A simple clinical method for predicting the benefit of prone vs. supine positioning in reducing heart exposure during left breast radiotherapy
| Autor: | Krisztina Boda, Renáta Kószó, Szilvia Gaál, Akos Gulyban, Philippe Coucke, Ferenc Rárosi, Barbara Darázs, Ferenc Lakosi, Adrienn Cserháti, Zsuzsanna Kahán, Zoltán Varga |
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| Rok vydání: | 2017 |
| Předmět: |
Prioritization
medicine.medical_specialty Supine position medicine.medical_treatment Breast Neoplasms Sensitivity and Specificity Heart protection Patient Positioning 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences 0302 clinical medicine Prone Position Supine Position Medicine Humans Radiology Nuclear Medicine and imaging 03.02. Klinikai orvostan Prospective Studies Prospective cohort study Lung business.industry Radiotherapy Planning Computer-Assisted Reproducibility of Results Heart Radiotherapy Dosage Hematology 03.05. Egyéb orvostudományok Clinical method Radiation therapy Left breast Oncology 030220 oncology & carcinogenesis Female Radiology Radiotherapy Conformal business Body mass index |
| Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 126(3) |
| ISSN: | 1879-0887 |
| Popis: | Background and purpose The benefit of reduced radiation heart exposure in the prone vs. supine position individually differs. In this prospective cohort study, the goal was to develop a simple method for the operation of a validated model for the prediction of preferable treatment position during left breast radiotherapy. Material and methods In 100 cases, a single CT slice was utilized for the collection of the needed patient-specific data (in addition to body mass index, the distance of the LAD from the chest wall and the area of the heart included in the radiation fields at the middle of the heart in the supine position). Outcome was analyzed in relation to the full CT series acquired in both positions and dosimetric data. Results Great consistency was found between the tested and original method regarding sensitivity and specificity. The prioritization of LAD dose, and the use of heart dose and position-specific dose constraints as safety measures ensure sensitivity and specificity values of 82.8% and 87.3%, respectively. In an additional “routine clinical practice” series of 60 patients the new method seemed feasible in routine clinical practice. External testing on a 28-case series indicated similar accuracy. Conclusion We consider this simple clinical tool appropriate for assisting individual positioning aiming at maximum heart protection during left breast irradiation. |
| Databáze: | OpenAIRE |
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