Prone versus supine positioning for whole and partial-breast radiotherapy: A comparison of non-target tissue dosimetry
Prone versus supine positioning for whole and partial-breast radiotherapy: A comparison of non-target tissue dosimetry
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DOI：
10.1016/j.radonc.2010.05.014
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发表时间：
2010-08-01
影响因子：
5.7
通讯作者：
Yarnold, John R.
中科院分区：
文献类型：
--
作者：
Kirby, Anna M.;Evans, Philip M.;Yarnold, John R.
目的比较非靶组织方法和材料：65例乳腺癌术后患者接受仰卧位和俯卧位CT成像。在每个数据集上，全乳房临床靶体积（WB-CTV），部分乳房CTV，（肿瘤床+15 mm）、同侧肺和胸壁轮廓在左侧病例中概述了心脏和LAD（n = 30）为每个位置生成切向场WBI和PBI计划。平均LAD、心脏和同侧肺剂量（x（平均值）），最大LAD（LAD（max））剂量，结果19/30戈伊全身照射（WBI）患者共生成260个计划，其中19例采用俯卧位减少心脏和LAD剂量（LAD（平均值）的中位降低值= 62戈伊）和7/30例PBI病例（LAD（最大值）的中位降低值= 29 3戈伊）（4/30例无差异）然而，俯卧位增加了8/30 WBI的心脏剂量（LAD（平均值）的中位增加= 95戈伊）和19/30例PBI病例（LAD（最大值）的中位增幅= 22 9戈伊）WB-CTV > 1000 cm（3）与俯卧位心脏剂量测定的改善有关（3/30例无差异）俯卧位65/65例Will和61/65例PBI病例的同侧肺（平均值）减少，所有WBI病例的胸壁V-50 Gy PBI与WBI相比，在所有病例中均减少正常组织剂量。结论在切向野WBI和PBI的背景下，俯卧位可能对乳房体积较大的左乳房受累女性有益，但对乳房体积较小的左乳房受累女性有害。(C)2010爱思唯尔爱尔兰有限公司版权所有放射治疗和肿瘤学96（2010）178-184
Purpose To compare non-target tissue (including left-anterior-descending coronary-artery (LAD)) dosimetry of prone versus supine whole (WBI) and partial-breast irradiation (PBI).Methods and materials Sixty-five post-lumpectomy breast cancer patients underwent CT-imaging supine and prone On each dataset, the whole-breast clinical-target-volume (WB-CTV), partial-breast CTV (tumour-bed + 15 mm), ipsilateral-lung and chest-wall were outlined Heart and LAD were outlined in left-sided cases (n = 30) Tangential-field WBI and PBI plans were generated for each position. Mean LAD, heart, and ipsilateral-lung doses (x(mean)), maximum LAD (LAD(max)) doses, and the volume of chest-wall receiving 50 Gy (V-50Gy) were comparedResults Two-hundred and sixty plans were generated Prone positioning reduced heart and LAD doses in 19/30 WBI cases (median reduction in LAD(mean) = 62 Gy) and 7/30 PBI cases (median reduction in LAD(max) = 29 3 Gy) (no difference in 4/30 cases) However, prone positioning increased cardiac doses in 8/30 WBI (median Increase in LAD(mean) = 95 Gy) and 19/30 PBI cases (median increase in LAD(max) = 22 9 Gy) (no difference in 3/30 cases) WB-CTV > 1000cm(3) was associated with improved cardiac dosimetry in the prone position for Will (p = 0.04) and PBI (p = 0 04) Prone positioning reduced ipsilateral-lung(mean) in 65/65 Will and 61/65 PBI cases, and chest-wall V-50Gy in all WBI cases PBI reduced normal-tissue doses compared to WBI in all cases. regardless of the treatment positionConclusions In the context of tangential-field WBI and PBI, prone positioning is likely to benefit left-breast-affected women of larger breast volume, but to be detrimental in left-breast-affected women of smaller breast volume Right-breast-affected women are likely to benefit from prone positioning regardless of breast volume. (C) 2010 Elsevier Ireland Ltd All rights reserved Radiotherapy and Oncology 96 (2010) 178-184