Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026
Accelerated Partial Breast Irradiation in the Supine vs Prone Position: A Comparison of Dosimetry and Acute Toxicity in a Real World Population.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wanna A, Barbee D, Kim J, Abeloos C H, Oh C, Solan A, Daniels T, Cahlon O, Gerber N K
Аннотация
AIMS: Our institution regularly offers accelerated partial breast irradiation (APBI) of 3000 cGy in 5 fractions. This study compares dosimetry and acute toxicities between patients treated in the prone and supine positions.
MATERIALS AND METHODS: We retrospectively reviewed all patients with in-situ or invasive breast cancer treated with 3000 cGy in 5 fractions of APBI at our institution between January 2022 and December 2023. We obtained dosimetric and acute toxicity data for each patient. Differences between treatment groups were analyzed using the Wilcoxon rank-sum, Pearson's Chi-squared and Fisher's exact tests.
RESULTS: A total of 168 patients were identified, with 134 (79.8%) treated prone and 34 (20.2%) treated supine. Of the supine patients, 23 (67.6%) were treated with photon-only plans and 11 (32.4%) with mixed photon-electron plans. There were no statistically significant differences in age, body mass index (BMI), tumor size, or breast laterality between the two groups. Planning target volume (PTV) volume was larger for prone patients (P = 0.002). Target coverage was excellent and similar in both positions. Ipsilateral breast dosimetry did not differ significantly between groups. Median mean heart dose (MHD) was significantly lower in prone patients (9.6 cGy vs 14.9 cGy, P = 0.033). This difference was more pronounced in right-sided patients than in left-sided patients (right: 6.9 cGy prone vs 8.6 cGy supine, P = 0.037; left: 17.6 cGy prone vs 16.5 cGy supine, P = 0.710). MHD was also significantly higher in mixed photon-electron plans (22.5 cGy) than in supine photon-only plans (10.6 cGy) P = 0.009. Mean ipsilateral lung V10 Gy was lower for prone patients (0.28% vs 1.44%, P =< 0.001). Grade 1-2 dermatitis was more frequent in the supine cohort (P = 0.029). Fatigue was significantly higher in patients with BMI ≥30 vs patients with BMI <30 (P = 0.035).
CONCLUSION: Both treatment positions were safe, and there were no differences in target coverage or ipsilateral breast dosimetry between the two groups. Prone positioning was associated with lower heart and lung doses as well as lower rates of acute dermatitis, but heart and lung doses were minimal regardless of treatment position.
MATERIALS AND METHODS: We retrospectively reviewed all patients with in-situ or invasive breast cancer treated with 3000 cGy in 5 fractions of APBI at our institution between January 2022 and December 2023. We obtained dosimetric and acute toxicity data for each patient. Differences between treatment groups were analyzed using the Wilcoxon rank-sum, Pearson's Chi-squared and Fisher's exact tests.
RESULTS: A total of 168 patients were identified, with 134 (79.8%) treated prone and 34 (20.2%) treated supine. Of the supine patients, 23 (67.6%) were treated with photon-only plans and 11 (32.4%) with mixed photon-electron plans. There were no statistically significant differences in age, body mass index (BMI), tumor size, or breast laterality between the two groups. Planning target volume (PTV) volume was larger for prone patients (P = 0.002). Target coverage was excellent and similar in both positions. Ipsilateral breast dosimetry did not differ significantly between groups. Median mean heart dose (MHD) was significantly lower in prone patients (9.6 cGy vs 14.9 cGy, P = 0.033). This difference was more pronounced in right-sided patients than in left-sided patients (right: 6.9 cGy prone vs 8.6 cGy supine, P = 0.037; left: 17.6 cGy prone vs 16.5 cGy supine, P = 0.710). MHD was also significantly higher in mixed photon-electron plans (22.5 cGy) than in supine photon-only plans (10.6 cGy) P = 0.009. Mean ipsilateral lung V10 Gy was lower for prone patients (0.28% vs 1.44%, P =< 0.001). Grade 1-2 dermatitis was more frequent in the supine cohort (P = 0.029). Fatigue was significantly higher in patients with BMI ≥30 vs patients with BMI <30 (P = 0.035).
CONCLUSION: Both treatment positions were safe, and there were no differences in target coverage or ipsilateral breast dosimetry between the two groups. Prone positioning was associated with lower heart and lung doses as well as lower rates of acute dermatitis, but heart and lung doses were minimal regardless of treatment position.