Reduction in Doses to Organs at Risk and Normal Tissue During Breast Radiation Therapy With a Carbon-Fiber Adjustable Reusable Accessory
| Autor: | Elisa K. Chan, Tania Arora, Robin Coope, Joel Singer, Emilie E. Carpentier, Alan Nichol, Peter Lim, Christina Aquino-Parsons, Paris-Anne Ingledew, Cheryl Duzenli, B Gill, Sheri Grahame, Tara Menna, Theodora Koulis |
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| Rok vydání: | 2021 |
| Předmět: |
Organs at Risk
Supine position medicine.medical_treatment Breast Neoplasms Pilot Projects Ptosis Carbon Fiber medicine Inframammary fold Humans Radiology Nuclear Medicine and imaging Reduction (orthopedic surgery) Lung business.industry Radiotherapy Planning Computer-Assisted Cancer Heart Radiotherapy Dosage medicine.disease Radiation therapy medicine.anatomical_structure Oncology Median body Female medicine.symptom Nuclear medicine business |
| Zdroj: | Practical radiation oncology. 11(6) |
| ISSN: | 1879-8519 |
| Popis: | Purpose This pilot study (ClinicalTrials.gov NCT04543851) investigates a novel breast positioning device using a low density, high tensile carbon-fiber cradle to support the breast, remove the inframammary fold, and reduce dose to organs at risk for whole breast radiation therapy in the supine position. Methods and Materials Thirty patients with inframammary folds ≥1 cm or lateral ptosis in supine treatment position were planned with standard positioning and with a carbon-fiber Adjustable Reusable Accessory (CARA) breast support. Twenty patients received whole breast with or without regional nodal irradiation with 42.5 Gy in 16 fractions or 50 Gy in 25 fractions using CARA. Median body mass index was 32 in this study. Results CARA removed all inframammary folds and reduced V20Gyipsilateral lung, V105%breast, and V50% body, without compromising target coverage. Median (range) V20Gyipsilateral lung for whole breast radiation therapy was 12.3% (1.4%-28.7%) with standard of care versus 10.9% (1.2%-17.3%) with CARA (Wilcoxon P = .005). Median V105% breast was 8.0% (0.0%-29%) with standard of care versus 4.0% (0.0%-23%) with CARA (P = .006) and median V50% body was 3056 mL (1476-5285 mL) versus 2780 mL (1415-5123 mL) with CARA (P = .001). CARA was compatible with deep inspiration breath hold and achieved median V25Gyheart = 0.1% (range 0%-1.9%) for all patients with left breast cancer. Skin reactions with CARA were consistent with historical data and daily variation in treatment setup was consistent with standard supine positioning. Conclusions CARA can reduce V105%breast, lung and normal tissue dose, and remove the inframammary fold for breast patients with large or pendulous breasts and high body mass index treated in the supine position, without compromising target coverage. CARA will undergo further study in a randomized controlled trial. |
| Databáze: | OpenAIRE |
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