A Dosimetric Comparison Between the Supine and Prone Positions for Three-Field Intact Breast Radiotherapy
| Autor: | Benjamin T. Gielda, Jonathan B. Strauss, James C. Marsh, Katherine L. Griem, Julius V. Turian |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Cancer Research Supine position medicine.medical_treatment Breast Neoplasms Breast radiotherapy Prone Position Supine Position Humans Medicine Radiation Injuries Lung Aged Retrospective Studies business.industry Radiotherapy Planning Computer-Assisted Dose fractionation Retrospective cohort study Middle Aged Radiation therapy Prone position Axilla medicine.anatomical_structure Oncology Organ at risk Feasibility Studies Female Radiotherapy Adjuvant Dose Fractionation Radiation Lymph Nodes Radiotherapy Conformal business Nuclear medicine |
| Zdroj: | American Journal of Clinical Oncology. 34:223-230 |
| ISSN: | 0277-3732 |
| Popis: | Purpose: Supine tangential radiotherapy for the intact breast is a standard component of breast conservation management; a supraclavicular (SCV) field can be added for patients at high risk for nodal failure. Treatment in the prone position has demonstrated improvements in lung sparing, but has been limited to early-stage patients in whom radiation to only the breast was indicated. We sought to investigate the dosimetric feasibility of treating women in the prone position, using a 3-field monoisocentric technique. Methods: A total of 10 patients previously simulated supine and prone were selected for replanning. The heart, ipsilateral breast, contralateral breast, and axillary/SCV lymph node regions were contoured in accordance with Radiation Therapy Oncology Group guidelines. The 3-field monoisocentric plans were created for both the supine and prone scans. Target coverage, homogeneity, and organ at risk sparing were examined. Results: Both plans achieved acceptable coverage of the breast. The mean percentage of the breast receiving at least 95% of the prescription dose (V95%) were similar in the prone and supine positions, 89.3% versus 90.7% (P = 0.29). Mean V95% of the level 3 axilla and SCV were 93.8% versus 97.0% prone versus supine (P = 0.16). The percentage of ipsilateral lung receiving >20 Gy was substantially reduced from 21.2% supine to 9.3% prone (P = 0.001). Conclusion: Three-field radiotherapy in the prone position appears to be dosimetrically equivalent to supine treatment with respect to target coverage, but the prone position decreases lung dose. |
| Databáze: | OpenAIRE |
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