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• W2088747374 abstract "Purpose/Objective(s)To analyze dosimetric parameters of patients candidates for adjuvant breast radiation therapy (RT) in the prone versus supine position.Materials/MethodsThirty-nine patients candidates for adjuvant breast RT with large and pendulous breasts, 23 right and 16 left sided, were included in the present study after obtaining informed consent. Age ranged from 30 to 74 (median 55 years) and BMI from 20 to 32 (median 24.2). All patients underwent CT-simulation in both prone and supine position. Clear-Vue breast board was used for prone and the breast Posiboard for supine patient setup. Target volumes and OARs (ipsilateral lung, heart, and left anterior descending [LAD] coronary artery for left sided breast) were outlined on CT simulation slices with 5 mm thickness. CTV was defined as the gland breast tissue starting 5 mm below the skin. PTV was obtained adding 5 mm margin to the CTV posteriorly and 10 mm cranial-caudally. The prescribed dose to the ICRU point was 50 Gy. Treatment plans were developed by applying 6-15 MV tangential photon fields. Dose homogeneity within the PTV was defined by the volume receiving at least 47.5 Gy but not less than 53.5 Gy (V95%-107%). Radiation exposure of the OARs (the volume of the ipsilateral lung, heart receiving more than 5 Gy, 10 Gy, and 20 Gy [V5 Gy, V10 Gy and V20 Gy], and the mean and maximum dose to the LAD) were registered in both positions.ResultsThe mean CTV in prone position (468 cc) was significantly larger than that in supine position (432 cc) (p = 0.02). PTV coverage in supine position (mean V95% = 98.0 ± 1.6) was significantly more homogeneous than in prone position (mean V95% = 96.5 ± 3.5; p = 0.04). Dmin, Dmean, Dmax, V105%, and V107% were not significantly different between the two setup positions. The lung V5, V10, and V20 were significantly less (p < 10−6) in prone than in supine position. The heart V5 Gy, V10 Gy, V20 Gy, and LAD Dmean and Dmax (analyzed in 16 left sided tumor patients) were less in prone than in supine position, but the difference was not statistically significant. The heart Dmax in patients with right breast was significantly lower in prone than in supine position (p = 0.001). Based on planning data and on patients' compliance, 27/39 patients (70%) were treated in prone position.ConclusionsProne position may offer an advantageous alternative for irradiation of mammary gland in patients with large and pendulous breasts in particular for lung tissue. The decreased dose in the OARs suggests that prone position could be useful also in patients with pulmonary and cardiac comorbidity. Purpose/Objective(s)To analyze dosimetric parameters of patients candidates for adjuvant breast radiation therapy (RT) in the prone versus supine position. To analyze dosimetric parameters of patients candidates for adjuvant breast radiation therapy (RT) in the prone versus supine position. Materials/MethodsThirty-nine patients candidates for adjuvant breast RT with large and pendulous breasts, 23 right and 16 left sided, were included in the present study after obtaining informed consent. Age ranged from 30 to 74 (median 55 years) and BMI from 20 to 32 (median 24.2). All patients underwent CT-simulation in both prone and supine position. Clear-Vue breast board was used for prone and the breast Posiboard for supine patient setup. Target volumes and OARs (ipsilateral lung, heart, and left anterior descending [LAD] coronary artery for left sided breast) were outlined on CT simulation slices with 5 mm thickness. CTV was defined as the gland breast tissue starting 5 mm below the skin. PTV was obtained adding 5 mm margin to the CTV posteriorly and 10 mm cranial-caudally. The prescribed dose to the ICRU point was 50 Gy. Treatment plans were developed by applying 6-15 MV tangential photon fields. Dose homogeneity within the PTV was defined by the volume receiving at least 47.5 Gy but not less than 53.5 Gy (V95%-107%). Radiation exposure of the OARs (the volume of the ipsilateral lung, heart receiving more than 5 Gy, 10 Gy, and 20 Gy [V5 Gy, V10 Gy and V20 Gy], and the mean and maximum dose to the LAD) were registered in both positions. Thirty-nine patients candidates for adjuvant breast RT with large and pendulous breasts, 23 right and 16 left sided, were included in the present study after obtaining informed consent. Age ranged from 30 to 74 (median 55 years) and BMI from 20 to 32 (median 24.2). All patients underwent CT-simulation in both prone and supine position. Clear-Vue breast board was used for prone and the breast Posiboard for supine patient setup. Target volumes and OARs (ipsilateral lung, heart, and left anterior descending [LAD] coronary artery for left sided breast) were outlined on CT simulation slices with 5 mm thickness. CTV was defined as the gland breast tissue starting 5 mm below the skin. PTV was obtained adding 5 mm margin to the CTV posteriorly and 10 mm cranial-caudally. The prescribed dose to the ICRU point was 50 Gy. Treatment plans were developed by applying 6-15 MV tangential photon fields. Dose homogeneity within the PTV was defined by the volume receiving at least 47.5 Gy but not less than 53.5 Gy (V95%-107%). Radiation exposure of the OARs (the volume of the ipsilateral lung, heart receiving more than 5 Gy, 10 Gy, and 20 Gy [V5 Gy, V10 Gy and V20 Gy], and the mean and maximum dose to the LAD) were registered in both positions. ResultsThe mean CTV in prone position (468 cc) was significantly larger than that in supine position (432 cc) (p = 0.02). PTV coverage in supine position (mean V95% = 98.0 ± 1.6) was significantly more homogeneous than in prone position (mean V95% = 96.5 ± 3.5; p = 0.04). Dmin, Dmean, Dmax, V105%, and V107% were not significantly different between the two setup positions. The lung V5, V10, and V20 were significantly less (p < 10−6) in prone than in supine position. The heart V5 Gy, V10 Gy, V20 Gy, and LAD Dmean and Dmax (analyzed in 16 left sided tumor patients) were less in prone than in supine position, but the difference was not statistically significant. The heart Dmax in patients with right breast was significantly lower in prone than in supine position (p = 0.001). Based on planning data and on patients' compliance, 27/39 patients (70%) were treated in prone position. The mean CTV in prone position (468 cc) was significantly larger than that in supine position (432 cc) (p = 0.02). PTV coverage in supine position (mean V95% = 98.0 ± 1.6) was significantly more homogeneous than in prone position (mean V95% = 96.5 ± 3.5; p = 0.04). Dmin, Dmean, Dmax, V105%, and V107% were not significantly different between the two setup positions. The lung V5, V10, and V20 were significantly less (p < 10−6) in prone than in supine position. The heart V5 Gy, V10 Gy, V20 Gy, and LAD Dmean and Dmax (analyzed in 16 left sided tumor patients) were less in prone than in supine position, but the difference was not statistically significant. The heart Dmax in patients with right breast was significantly lower in prone than in supine position (p = 0.001). Based on planning data and on patients' compliance, 27/39 patients (70%) were treated in prone position. ConclusionsProne position may offer an advantageous alternative for irradiation of mammary gland in patients with large and pendulous breasts in particular for lung tissue. The decreased dose in the OARs suggests that prone position could be useful also in patients with pulmonary and cardiac comorbidity. Prone position may offer an advantageous alternative for irradiation of mammary gland in patients with large and pendulous breasts in particular for lung tissue. The decreased dose in the OARs suggests that prone position could be useful also in patients with pulmonary and cardiac comorbidity." @default.
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• W2088747374 title "Prone Versus Supine Position for Adjuvant Breast Radiation Therapy: A Comparative Planning Study" @default.
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