Advanced search
1 file | 1.46 MB

Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer

Pieter Deseyne (UGent) , Bruno Speleers (UGent) , Wilfried De Neve (UGent) , Bert Boute (UGent) , Leen Paelinck (UGent) , Tom Van Hoof (UGent) , Joris Van de Velde (UGent) , Annick Van Greveling (UGent) , Christel Monten (UGent) , Giselle Post (UGent) , et al.
Author
Organization
Abstract
Background: Prone whole breast irradiation (WBI) leads to reduced heart and lung doses in breast cancer patients receiving adjuvant radiotherapy. In this feasibility trial, we investigated the prone position for whole breast + lymph node irradiation (WB + LNI). Methods: A new support device was developed for optimal target coverage, on which patients are positioned in a position resembling a phase from the crawl swimming technique (prone crawl position). Five left sided breast cancer patients were included and simulated in supine and prone position. For each patient, a treatment plan was made in prone and supine position for WB + LNI to the whole axilla and the unoperated part of the axilla. Patients served as their own controls for comparing dosimetry of target volumes and organs at risk (OAR) in prone versus in supine position. Results: Target volume coverage differed only slightly between prone and supine position. Doses were significantly reduced (P < 0.05) in prone position for ipsilateral lung (Dmean, D2, V5, V10, V20, V30), contralateral lung (Dmean, D2), contralateral breast (Dmean, D2 and for total axillary WB + LNI also V5), thyroid (Dmean, D2, V5, V10, V20, V30), oesophagus (Dmean and for partial axillary WB + LNI also D2 and V5), skin (D2 and for partial axillary WB + LNI V105 and V107). There were no significant differences for heart and humeral head doses. Conclusions: Prone crawl position in WB + LNI allows for good breast and nodal target coverage with better sparing of ipsilateral lung, thyroid, contralateral breast, contralateral lung and oesophagus when compared to supine position. There is no difference in heart and humeral head doses.
Keywords
Adjuvant radiotherapy, Breast irradiation, Regional nodal irradiation, Breast cancer, Prone position, Prone crawl position, Dosimetry, Organs at risk, VMAT, INTENSITY-MODULATED RADIOTHERAPY, ELECTIVE RADIATION-THERAPY, ESTRO CONSENSUS GUIDELINE, TARGET VOLUME DELINEATION, POPULATION-BASED COHORT, TRIAL COMPARING PRONE, AXILLARY LYMPH-NODES, CONTRALATERAL BREAST, INTERNAL MAMMARY, LUNG-CANCER

Downloads

  • Deseyne lymph nodes in prone position.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 1.46 MB

Citation

Please use this url to cite or link to this publication:

Chicago
Deseyne, Pieter, Bruno Speleers, Wilfried De Neve, Bert Boute, LEEN PAELINCK, Tom Van Hoof, Joris Van de Velde, et al. 2017. “Whole Breast and Regional Nodal Irradiation in Prone Versus Supine Position in Left Sided Breast Cancer.” Radiation Oncology 12.
APA
Deseyne, P., Speleers, B., De Neve, W., Boute, B., PAELINCK, L., Van Hoof, T., Van de Velde, J., et al. (2017). Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer. RADIATION ONCOLOGY, 12.
Vancouver
1.
Deseyne P, Speleers B, De Neve W, Boute B, PAELINCK L, Van Hoof T, et al. Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer. RADIATION ONCOLOGY. 2017;12.
MLA
Deseyne, Pieter, Bruno Speleers, Wilfried De Neve, et al. “Whole Breast and Regional Nodal Irradiation in Prone Versus Supine Position in Left Sided Breast Cancer.” RADIATION ONCOLOGY 12 (2017): n. pag. Print.
@article{8521464,
  abstract     = {Background: Prone whole breast irradiation (WBI) leads to reduced heart and lung doses in breast cancer patients receiving adjuvant radiotherapy. In this feasibility trial, we investigated the prone position for whole breast + lymph node irradiation (WB + LNI). 
Methods: A new support device was developed for optimal target coverage, on which patients are positioned in a position resembling a phase from the crawl swimming technique (prone crawl position). Five left sided breast cancer patients were included and simulated in supine and prone position. For each patient, a treatment plan was made in prone and supine position for WB + LNI to the whole axilla and the unoperated part of the axilla. Patients served as their own controls for comparing dosimetry of target volumes and organs at risk (OAR) in prone versus in supine position. 
Results: Target volume coverage differed only slightly between prone and supine position. Doses were significantly reduced (P {\textlangle} 0.05) in prone position for ipsilateral lung (Dmean, D2, V5, V10, V20, V30), contralateral lung (Dmean, D2), contralateral breast (Dmean, D2 and for total axillary WB + LNI also V5), thyroid (Dmean, D2, V5, V10, V20, V30), oesophagus (Dmean and for partial axillary WB + LNI also D2 and V5), skin (D2 and for partial axillary WB + LNI V105 and V107). There were no significant differences for heart and humeral head doses. 
Conclusions: Prone crawl position in WB + LNI allows for good breast and nodal target coverage with better sparing of ipsilateral lung, thyroid, contralateral breast, contralateral lung and oesophagus when compared to supine position. There is no difference in heart and humeral head doses.},
  articleno    = {89},
  author       = {Deseyne, Pieter and Speleers, Bruno and De Neve, Wilfried and Boute, Bert and Paelinck, Leen and Van Hoof, Tom and Van de Velde, Joris and Van Greveling, Annick and Monten, Christel and Post, Giselle and Depypere, Herman and Veldeman, Liv},
  issn         = {1748-717X},
  journal      = {RADIATION ONCOLOGY},
  keyword      = {Adjuvant radiotherapy,Breast irradiation,Regional nodal irradiation,Breast cancer,Prone position,Prone crawl position,Dosimetry,Organs at risk,VMAT,INTENSITY-MODULATED RADIOTHERAPY,ELECTIVE RADIATION-THERAPY,ESTRO CONSENSUS GUIDELINE,TARGET VOLUME DELINEATION,POPULATION-BASED COHORT,TRIAL COMPARING PRONE,AXILLARY LYMPH-NODES,CONTRALATERAL BREAST,INTERNAL MAMMARY,LUNG-CANCER},
  language     = {eng},
  pages        = {12},
  title        = {Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer},
  url          = {http://dx.doi.org/10.1186/s13014-017-0828-6},
  volume       = {12},
  year         = {2017},
}

Altmetric
View in Altmetric
Web of Science
Times cited: