Single dose partial breast irradiation using an MRI linear accelerator in the supine and prone treatment position
| Autor: | H.J.G.D. Van den Bongard, Helena M. Verkooijen, M.E.P. Philippens, Sua Yoo, T. van't Westeinde, Janet K. Horton, B. Van Asselen, Antonetta C. Houweling, A Rodrigues, K.R. Charaghvandi |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Supine position
medicine.medical_treatment R895-920 Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Breast cancer Journal Article Medicine Dosimetry Radiology Nuclear Medicine and imaging In patient RC254-282 business.industry Partial Breast Irradiation Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease 3. Good health Radiation therapy Position (obstetrics) Oncology 030220 oncology & carcinogenesis business Breast carcinoma Nuclear medicine |
| Zdroj: | Clinical and Translational Radiation Oncology Clinical and Translational Radiation Oncology, Vol 14, Iss, Pp 1-7 (2019) Clinical and translational radiation oncology, 14, 1 |
| ISSN: | 2405-6308 |
| Popis: | Highlights • All MRI-linac plans met the coverage and predefined OAR constraints. • The prone approach appeared to be more favorable with respect to the chest wall, and ipsilateral lung dose compared to the supine position. • Overall, the MRI-linac and clinical plans were comparable, with minor absolute dosimetric differences. Background In selected patients with early-stage and low-risk breast cancer, an MRI-linac based treatment might enable a radiosurgical, non-invasive alternative for current standard breast conserving therapy. Aim To investigate whether single dose accelerated partial breast (APBI) to the intact tumor in both the prone and supine radiotherapy positions on the MRI-linac is dosimetrically feasible with respect to predefined coverage and organs at risk (OAR) constraints. Material & methods For 20 patients with cTis or low-risk cT1N0M0 non-lobular breast carcinoma, previously treated with single dose preoperative APBI in the supine (n = 10) or prone (n = 10) position, additional intensity modulated radiotherapy plans with 7 coplanar beams in the presence of a 1.5T magnetic field were generated. A 20 Gy and 15 Gy dose was prescribed to the gross tumor and clinical target volume, respectively. The percentage of plans achieving predefined organ at risk (OAR) constraints, currently used in clinical practice, was assessed. Dosimetry differences between the prone versus supine approach and the MRI-linac versus clinically delivered plans were evaluated. Results All MRI-linac plans met the coverage and predefined OAR constraints. The prone approach appeared to be more favorable with respect to the chest wall, and ipsilateral lung dose compared to the supine position. No dosimetric differences were observed for the ipsilateral breast. No treatment position was clearly more beneficial for the skin or heart, since dosimetry varied among parameters. Overall, the MRI-linac and clinical plans were comparable, with minor absolute dosimetric differences. Conclusion MRI-linac based single dose APBI to the intact tumor is a promising and a dosimetrically feasible strategy in patients with low-risk breast cancer. Preliminary OAR dosimetry favored the prone radiotherapy position. |
| Databáze: | OpenAIRE |
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