Prospective study of postoperative whole breast radiotherapy for Japanese large-breasted women: a clinical and dosimetric comparisons between supine and prone positions and a dose measurement using a breast phantom.
Prospective study of postoperative whole breast radiotherapy for Japanese large-breasted women: a clinical and dosimetric comparisons between supine and prone positions and a dose measurement using a breast phantom.
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DOI：
10.1186/s12885-016-2794-z
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发表时间：
2016-09-29
期刊：
影响因子：
3.8
通讯作者：
Itami J
中科院分区：
文献类型：
--
作者：
Takahashi K;Morota M;Kagami Y;Okamoto H;Sekii S;Inaba K;Murakami N;Igaki H;Ito Y;Uno T;Itami J
本前瞻性研究旨在比较仰卧位和俯卧位全乳放疗的乳房和危险器官（OAR）的剂量体积直方图（DVH），并分析急性和晚期毒性的频率和严重程度。接受部分乳房切除术的早期乳腺癌患者（日本胸罩尺寸C或更大，或胸围最宽测量值≥ 95 cm）参加了本研究。在每个位置制定基于CT的治疗计划，并计算乳腺和OAR的各种剂量学参数，以比较仰卧和俯卧放疗计划。在被认为更好的位置进行实际治疗。从2009年到2010年，前瞻性地招募了22例患者。中位随访时间为58个月。俯卧位的均匀性指数和肺剂量显著较低（分别为P = 0.008、P < 0.0001和P < 0.0001）。心脏剂量在两个位置之间无显著差异。通过比较两种方案，77%的患者选择俯卧位.在俯卧位时，47%的治疗患者发生≥ 2级急性皮炎，而在仰卧位时，20%的治疗患者发生2级急性皮炎，无3级急性皮炎病例，尽管两种体位之间≥ 2级急性皮炎的发生率无统计学意义（P = 0.28）。使用乳房体模进行的实际剂量测量显示，俯卧位治疗的乳房表面剂量显著高于仰卧位。俯卧位乳房照射改善了PTV的均匀性，降低了日本大乳房患者的OAR剂量。然而，仔细定位乳房在俯卧板避免团效应是必要的，以防止急性皮炎。
This prospective study aimed to compare dose volume histograms (DVH) of the breasts and organs at risk (OARs) of whole breast radiotherapy in the supine and prone positions, and frequency and severity of acute and late toxicities were analyzed. Early-stage breast cancer patients with large breasts (Japanese bra size C or larger, or the widest measurements of the bust ≥ 95 cm) undergoing partial mastectomy participated in this study. CT-based treatment plans were made in each position, and various dosimetric parameters for the breast and OARs were calculated to compare the supine and prone radiotherapy plans. The actual treatment was delivered in the position regarded as better. From 2009 to 2010, 22 patients were prospectively accrued. Median follow-up period was 58 months. The homogeneity index and lung doses were significantly lower in the prone position (P = 0.008, P < 0.0001 and P < 0.0001, respectively). Cardiac dose showed no significant differences between two positions. By comparing two plans, the prone position was chosen in 77 % of the patients. In the prone position, ≥ grade 2 acute dermatitis were seen in 47 % of patients treated, whereas 20 % of the patients treated in the supine position had grade 2 and no cases of grade 3, although without a statistical significance of the rates of ≥ grade 2 acute dermatitis between the two positions (P = 0.28). The actual dose measurement using a breast phantom revealed significantly higher surface dose of the breast treated in the prone position than that in the supine position. Breast irradiation in the prone position improves PTV homogeneity and lowers doses to the OARs in the Japanese large-breast patients. However meticulous positioning of the breast in the prone board avoiding the bolus effect is necessary to prevent acute dermatitis.
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影响因子：
158.5
作者：
Darby, Sarah C.;Ewertz, Marianne;Hall, Per
通讯作者：
Hall, Per
DOI：
10.1016/s1470-2045(14)70460-7
发表时间：
2014-11
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Donker M;van Tienhoven G;Straver ME;Meijnen P;van de Velde CJ;Mansel RE;Cataliotti L;Westenberg AH;Klinkenbijl JH;Orzalesi L;Bouma WH;van der Mijle HC;Nieuwenhuijzen GA;Veltkamp SC;Slaets L;Duez NJ;de Graaf PW;van Dalen T;Marinelli A;Rijna H;Snoj M;Bundred NJ;Merkus JW;Belkacemi Y;Petignat P;Schinagl DA;Coens C;Messina CG;Bogaerts J;Rutgers EJ
通讯作者：
Rutgers EJ
DOI：
10.1016/s0360-3016(97)00292-7
发表时间：
1997-08-01
影响因子：
7
作者：
Buchholz, TA;Gurgoze, E;Prestidge, BR
通讯作者：
Prestidge, BR
DOI：
10.1016/j.ijrobp.2011.08.020
发表时间：
2012-07-01
影响因子：
7
作者：
Bergom, Carmen;Kelly, Tracy;Morrow, Natalya;Wilson, J. Frank;Walker, Alonzo;Xiang, Qun;Ahn, Kwang Woo;White, Julia
通讯作者：
White, Julia
影响因子：
5.7
作者：
Kirby, Anna M.;Evans, Philip M.;Yarnold, John R.
通讯作者：
Yarnold, John R.