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Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes

Since December 2009, after breast-conserving surgery for Stage 0–I cancer of the left breast, 21 women with relatively pendulous breasts underwent computed tomography prone and supine simulations. The adjuvant radiotherapy was 50 Gy in 25 fractions to the left breast alone. Four plans—conventional w...

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Autores principales: Chen, Jenny Ling-Yu, Cheng, Jason Chia-Hsien, Kuo, Sung-Hsin, Chan, Hsing-Min, Huang, Yu-Sen, Chen, Yu-Hsuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766291/
https://www.ncbi.nlm.nih.gov/pubmed/23504450
http://dx.doi.org/10.1093/jrr/rrt019
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author Chen, Jenny Ling-Yu
Cheng, Jason Chia-Hsien
Kuo, Sung-Hsin
Chan, Hsing-Min
Huang, Yu-Sen
Chen, Yu-Hsuan
author_facet Chen, Jenny Ling-Yu
Cheng, Jason Chia-Hsien
Kuo, Sung-Hsin
Chan, Hsing-Min
Huang, Yu-Sen
Chen, Yu-Hsuan
author_sort Chen, Jenny Ling-Yu
collection PubMed
description Since December 2009, after breast-conserving surgery for Stage 0–I cancer of the left breast, 21 women with relatively pendulous breasts underwent computed tomography prone and supine simulations. The adjuvant radiotherapy was 50 Gy in 25 fractions to the left breast alone. Four plans—conventional wedged tangents and forward intensity-modulated radiotherapy (fIMRT) in supine and prone positions—were generated. fIMRT generated better homogeneity in both positions. Prone position centralized the breast tissue by gravity and also shortened the breast width which led to better conformity in both planning techniques. Prone fIMRT significantly reduced doses to left lung, Level I and Level II axilla. The mean cardiac doses did not differ between positions. Among the four plans, prone fIMRT produced the best target dosimetry and normal organ sparing. In subgroup analysis, patients with absolute breast depth > 7 cm in the prone position or breast depth difference > 3 cm between positions had significant cardiac sparing with prone fIMRT. Sixteen patients with significant cardiac sparing in prone position were treated using prone fIMRT and the others using supine fIMRT. All patients received a supine electron tumor bed boost of 10 Gy in 5 fractions. No patients developed Grade 2 or worse acute or late toxicities. There was no difference in the number of segments or beams, monitor units, treatment time, or positioning reproducibility between prone and supine positions. At a median follow-up time of 26.8 months, no locoregional or distant recurrence or death was noted.
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spelling pubmed-37662912013-09-09 Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes Chen, Jenny Ling-Yu Cheng, Jason Chia-Hsien Kuo, Sung-Hsin Chan, Hsing-Min Huang, Yu-Sen Chen, Yu-Hsuan J Radiat Res Oncology Since December 2009, after breast-conserving surgery for Stage 0–I cancer of the left breast, 21 women with relatively pendulous breasts underwent computed tomography prone and supine simulations. The adjuvant radiotherapy was 50 Gy in 25 fractions to the left breast alone. Four plans—conventional wedged tangents and forward intensity-modulated radiotherapy (fIMRT) in supine and prone positions—were generated. fIMRT generated better homogeneity in both positions. Prone position centralized the breast tissue by gravity and also shortened the breast width which led to better conformity in both planning techniques. Prone fIMRT significantly reduced doses to left lung, Level I and Level II axilla. The mean cardiac doses did not differ between positions. Among the four plans, prone fIMRT produced the best target dosimetry and normal organ sparing. In subgroup analysis, patients with absolute breast depth > 7 cm in the prone position or breast depth difference > 3 cm between positions had significant cardiac sparing with prone fIMRT. Sixteen patients with significant cardiac sparing in prone position were treated using prone fIMRT and the others using supine fIMRT. All patients received a supine electron tumor bed boost of 10 Gy in 5 fractions. No patients developed Grade 2 or worse acute or late toxicities. There was no difference in the number of segments or beams, monitor units, treatment time, or positioning reproducibility between prone and supine positions. At a median follow-up time of 26.8 months, no locoregional or distant recurrence or death was noted. Oxford University Press 2013-09 2013-03-15 /pmc/articles/PMC3766291/ /pubmed/23504450 http://dx.doi.org/10.1093/jrr/rrt019 Text en © The Author 2013. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Therapeutic Radiology and Oncology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Oncology
Chen, Jenny Ling-Yu
Cheng, Jason Chia-Hsien
Kuo, Sung-Hsin
Chan, Hsing-Min
Huang, Yu-Sen
Chen, Yu-Hsuan
Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
title Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
title_full Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
title_fullStr Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
title_full_unstemmed Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
title_short Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
title_sort prone breast forward intensity-modulated radiotherapy for asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766291/
https://www.ncbi.nlm.nih.gov/pubmed/23504450
http://dx.doi.org/10.1093/jrr/rrt019
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