Prone Hypofractionated Whole-Breast Radiotherapy Without a Boost to the Tumor Bed: Comparable Toxicity of IMRT Versus a 3D Conformal Technique

Hardee, Matthew E.; Raza, Shahzad; Becker, S; Jozsef, Gabor; Lymberis, S.; Hochman, Tsivia; Goldberg, Judith D.; DeWyngaert, K.; Formenti, Silvia C.

doi:10.1016/j.ijrobp.2011.06.1950

Cited by 45 publications

(36 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Reduction of the CBCT acquisition time to perform imaging during one breath hold should also be examined. Our results and others [15,26,32,33] confirm the ability of prone (DIBH) WBI to achieve an excellent acute toxicity profile, only 2/28 patients developed moist desquamation.…”

Section: Discussionsupporting

confidence: 85%

Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

Mulliez

Veldeman

Speleers

et al. 2015

Radiotherapy and Oncology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 85%

Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

Mulliez

Veldeman

Speleers

et al. 2015

Radiotherapy and Oncology

View full text Add to dashboard Cite

“…Hardee et al have questioned the need of intensitymodulated radiotherapy (IMRT) in prone [34]. They found that breast IMRT significantly improved dosimetry but provided only a modest benefit in terms of toxicity.…”

Section: Discussionmentioning

confidence: 99%

Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Lakosi¹,

Gulybán²,

Simoni³

et al. 2016

Cancer/Radiothérapie

View full text Add to dashboard Cite

show abstract

“…Another study comparing MB-IMRT, TF-IMRT and 3D-CRT treatment plans of 5 patients planned in prone position reported significantly higher dose homogeneity of MB-IMRT plans vs. TF-IMRT (p=0.003) and 3D-CRT plans (p=0.03) [23]. Hardee et al [14] observed a maximum dose reduction and improved median dose homogeneity in a prone TF-IMRT vs. 3D-CRT patient cohort. Moreover a 9%-decrease of grade 2 dermatitis and a 16%-reduction of grade ≥2 hyperpigmentation were found in the IMRT group.…”

Section: Discussionmentioning

confidence: 99%

“…Prone W-TF has previously been used for large, pendulous breasts [11] to reduce fibrosis and improve cosmesis [12,13]. There are a few studies reporting improved dosimetry by prone TF-IMRT [14-16], though data on whole-breast MB-IMRT in prone position are lacking. Moreover, all dosimetric studies comparing prone and supine position used only non-multi-beam techniques [16-20].…”

Section: Introductionmentioning

confidence: 99%

Whole breast radiotherapy in prone and supine position: is there a place for multi-beam IMRT?

et al. 2013

View full text Add to dashboard Cite

BackgroundEarly stage breast cancer patients are long-term survivors and finding techniques that may lower acute and late radiotherapy-induced toxicity is crucial. We compared dosimetry of wedged tangential fields (W-TF), tangential field intensity-modulated radiotherapy (TF-IMRT) and multi-beam IMRT (MB-IMRT) in prone and supine positions for whole-breast irradiation (WBI).MethodsMB-IMRT, TF-IMRT and W-TF treatment plans in prone and supine positions were generated for 18 unselected breast cancer patients. The median prescription dose to the optimized planning target volume (PTVoptim) was 50 Gy in 25 fractions. Dose-volume parameters and indices of conformity were calculated for the PTVoptim and organs-at-risk.ResultsProne MB-IMRT achieved (p<0.01) the best dose homogeneity compared to WTF in the prone position and WTF and MB-IMRT in the supine position. Prone IMRT scored better for all dose indices. MB-IMRT lowered lung and heart dose (p<0.05) in supine position, however the lowest ipsilateral lung doses (p<0.001) were in prone position. In left-sided breast cancer patients population averages for heart sparing by radiation dose was better in prone position; though non-significant. For patients with a PTVoptim volume ≥600 cc heart dose was consistently lower in prone position; while for patients with smaller breasts heart dose metrics were comparable or worse compared to supine MB-IMRT. Doses to the contralateral breast were similar regardless of position or technique. Dosimetry of prone MB-IMRT and prone TF-IMRT differed slightly.ConclusionsMB-IMRT is the treatment of choice in supine position. Prone IMRT is superior to any supine treatment for right-sided breast cancer patients and left-sided breast cancer patients with larger breasts by obtaining better conformity indices, target dose distribution and sparing of the organs-at-risk. The influence of treatment techniques in prone position is less pronounced; moreover dosimetric differences between TF-IMRT and MB-IMRT are rather small.

show abstract

Prone Hypofractionated Whole-Breast Radiotherapy Without a Boost to the Tumor Bed: Comparable Toxicity of IMRT Versus a 3D Conformal Technique

Cited by 45 publications

References 34 publications

Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Whole breast radiotherapy in prone and supine position: is there a place for multi-beam IMRT?

Contact Info

Product

Resources

About