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Radiation Oncology
Published in: Radiation Oncology 1/2017

Open Access 01-12-2017 | Research

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

Authors: Pieter Deseyne, Bruno Speleers, Wilfried De Neve, Bert Boute, Leen Paelinck, Tom Van Hoof, Joris Van de Velde, Annick Van Greveling, Chris Monten, Giselle Post, Herman Depypere, Liv Veldeman

Published in: Radiation Oncology | Issue 1/2017

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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.

Trial registration

No trial registration was performed because there were no therapeutic interventions.
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Metadata
Title
Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer
Authors
Pieter Deseyne
Bruno Speleers
Wilfried De Neve
Bert Boute
Leen Paelinck
Tom Van Hoof
Joris Van de Velde
Annick Van Greveling
Chris Monten
Giselle Post
Herman Depypere
Liv Veldeman
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-017-0828-6

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