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Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis

PURPOSE: The advantage of prone setup compared with supine for left-breast radiotherapy is controversial. We evaluate the dosimetric gain of prone setup and aim to identify predictors of the gain. METHODS: Left-sided breast cancer patients who had dual computed tomography (CT) planning in prone free...

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Autores principales: Wang, Xinzhuo, Fargier-Bochaton, Odile, Dipasquale, Giovanna, Laouiti, Mohamed, Kountouri, Melpomeni, Gorobets, Olena, Nguyen, Nam P., Miralbell, Raymond, Vinh-Hung, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987627/
https://www.ncbi.nlm.nih.gov/pubmed/33416915
http://dx.doi.org/10.1007/s00066-020-01731-8
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author Wang, Xinzhuo
Fargier-Bochaton, Odile
Dipasquale, Giovanna
Laouiti, Mohamed
Kountouri, Melpomeni
Gorobets, Olena
Nguyen, Nam P.
Miralbell, Raymond
Vinh-Hung, Vincent
author_facet Wang, Xinzhuo
Fargier-Bochaton, Odile
Dipasquale, Giovanna
Laouiti, Mohamed
Kountouri, Melpomeni
Gorobets, Olena
Nguyen, Nam P.
Miralbell, Raymond
Vinh-Hung, Vincent
author_sort Wang, Xinzhuo
collection PubMed
description PURPOSE: The advantage of prone setup compared with supine for left-breast radiotherapy is controversial. We evaluate the dosimetric gain of prone setup and aim to identify predictors of the gain. METHODS: Left-sided breast cancer patients who had dual computed tomography (CT) planning in prone free breathing (FB) and supine deep inspiration breath-hold (DiBH) were retrospectively identified. Radiation doses to heart, lungs, breasts, and tumor bed were evaluated using the recently developed mean absolute dose deviation (MADD). MADD measures how widely the dose delivered to a structure deviates from a reference dose specified for the structure. A penalty score was computed for every treatment plan as a weighted sum of the MADDs normalized to the breast prescribed dose. Changes in penalty scores when switching from supine to prone were assessed by paired t-tests and by the number of patients with a reduction of the penalty score (i.e., gain). Robust linear regression and fractional polynomials were used to correlate patients’ characteristics and their respective penalty scores. RESULTS: Among 116 patients identified with dual CT planning, the prone setup, compared with supine, was associated with a dosimetric gain in 72 (62.1%, 95% CI: 52.6–70.9%). The most significant predictors of a gain with the prone setup were the breast depth prone/supine ratio (>1.6), breast depth difference (>31 mm), prone breast depth (>77 mm), and breast volume (>282 mL). CONCLUSION: Prone compared with supine DiBH was associated with a dosimetric gain in 62.1% of our left-sided breast cancer patients. High pendulousness and moderately large breast predicted for the gain.
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spelling pubmed-79876272021-04-12 Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis Wang, Xinzhuo Fargier-Bochaton, Odile Dipasquale, Giovanna Laouiti, Mohamed Kountouri, Melpomeni Gorobets, Olena Nguyen, Nam P. Miralbell, Raymond Vinh-Hung, Vincent Strahlenther Onkol Original Article PURPOSE: The advantage of prone setup compared with supine for left-breast radiotherapy is controversial. We evaluate the dosimetric gain of prone setup and aim to identify predictors of the gain. METHODS: Left-sided breast cancer patients who had dual computed tomography (CT) planning in prone free breathing (FB) and supine deep inspiration breath-hold (DiBH) were retrospectively identified. Radiation doses to heart, lungs, breasts, and tumor bed were evaluated using the recently developed mean absolute dose deviation (MADD). MADD measures how widely the dose delivered to a structure deviates from a reference dose specified for the structure. A penalty score was computed for every treatment plan as a weighted sum of the MADDs normalized to the breast prescribed dose. Changes in penalty scores when switching from supine to prone were assessed by paired t-tests and by the number of patients with a reduction of the penalty score (i.e., gain). Robust linear regression and fractional polynomials were used to correlate patients’ characteristics and their respective penalty scores. RESULTS: Among 116 patients identified with dual CT planning, the prone setup, compared with supine, was associated with a dosimetric gain in 72 (62.1%, 95% CI: 52.6–70.9%). The most significant predictors of a gain with the prone setup were the breast depth prone/supine ratio (>1.6), breast depth difference (>31 mm), prone breast depth (>77 mm), and breast volume (>282 mL). CONCLUSION: Prone compared with supine DiBH was associated with a dosimetric gain in 62.1% of our left-sided breast cancer patients. High pendulousness and moderately large breast predicted for the gain. Springer Berlin Heidelberg 2021-01-08 2021 /pmc/articles/PMC7987627/ /pubmed/33416915 http://dx.doi.org/10.1007/s00066-020-01731-8 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Wang, Xinzhuo
Fargier-Bochaton, Odile
Dipasquale, Giovanna
Laouiti, Mohamed
Kountouri, Melpomeni
Gorobets, Olena
Nguyen, Nam P.
Miralbell, Raymond
Vinh-Hung, Vincent
Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis
title Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis
title_full Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis
title_fullStr Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis
title_full_unstemmed Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis
title_short Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis
title_sort is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? a dosimetric analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987627/
https://www.ncbi.nlm.nih.gov/pubmed/33416915
http://dx.doi.org/10.1007/s00066-020-01731-8
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