Left Sided Breast Cancer Irradiation ; Prone or Supine Simulation ?

Year 2022, Volume: 32 Issue: 2, 138 - 143, 29.04.2022

Yasemin Güzle Adaş , Esra Kekilli

https://doi.org/10.54005/geneltip.1014659

Abstract

Aim: The aim of this study was to compare radiation doses of target volumes and critical organs among prone and supine positions for left-sided breast cancer patients who were treated with breast-conserving surgery and adjuvant radiotherapy.
Materials and Methods: The doses of critical organs and target volumes were evaluated by using dose-volume histograms on the new radiotherapy plans of twenty patients.
Results: The mean heart dose was lower in the prone position (mean heart doses 656cGy and 933cGy respectively p = 0.01). Mean lung doses for prone and supine positions were 396 cGy and 1032 cGy (p =0.01); lung V5 13% and 33% (p =0.01); lung V10 8% and 25% (p =0.01); lung V20 5% and 17% (p =0.01).
Conclusion: Considering that lower doses of normal structures may reduce side effects, prone position may be preferred in patients with left breast cancer.

Keywords

breast cancer, radiotherapy, prone position, supine position

Sol Meme Kanseri Radyoterapisi Simülasyonunda Pron pozisyon mu Supin pozisyon mu ?

Abstract

Amaç : Bu çalışmanın amacı meme koruyucu cerrahi sonrası adjuvant radyoterapi uygulanmış sol meme kanseri tanısı olan hastalarda pron ve supin radyoterapi pozisyonlarının hedef hakim ve kritik organ dozları açısından karşılaştırılmasıdır.
Gereç ve Yöntem : Hedef hakim ve kritik organ dozları doz-hacim histogramları kullanılarak değerlendirildi.
Bulgular : Ortalama kalp dozu pron pozisyonda düşük bulundu ( pron ve supin pozisyon için sırasıyla 656 cGy ve 933 cGy ( p=0.01) bulundu. Pron ve supin pozisyonlar için ortalama akciğer dozları sırasıyla 396 cGy ve 1032 cGy (p=0.01); akciğer V5 %13 ve %33 (p=0.01); akciğer V10 %8 ve %25 (p=0.01); akciğer akciğer V20 %5 ve %17 (p=0.01) olarak tespit edildi.
Sonuç: Kritik organlardaki düşük dozlar değerlendirildiğinde sol meme kanseri radyoterapisinde prone poziyonun tercih edilebileceği söylenebilir.
Anahtar Kelimeler : Meme kanseri, radyoterapi, pron pozisyon , supin pozisyon

Keywords

Meme kanseri, radyoterapi, pron pozisyon, supin pozisyon

References

• 1.DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019. CA Cancer J Clin 2019;69(6):438-451.
• 2.Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347(16):1233-1241.
• 3.Early Breast Cancer Trialists' Collaborative G. Effects of radiotherapy and surgery in early breast cancer. An overview of the randomized trials. N Engl J Med 1995;333(22):1444-1455.
• 4.Van Dongen JA, Voogd AC, Fentiman IS, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 2000;92(14):1143-1150.
• 5.Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002;347(16):1227-1232.
• 6.Darby SC, McGale P, Taylor CW, Peto R. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. Lancet Oncol 2005;6(8):557-565.
• 7.Henson KE, McGale P, Taylor C, Darby SC. Radiation-related mortality from heart disease and lung cancer more than 20 years after radiotherapy for breast cancer. Br J Cancer 2013;108(1):179-182.
• 8.Nielsen MH, Berg M, Pedersen AN, et al. Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer: national guidelines and contouring atlas by the Danish Breast Cancer Cooperative Group. Acta Oncol 2013;52(4):703-710.
• 9.Moiseenko V, Einck J, Murphy J, et al. Clinical evaluation of QUANTEC guidelines to predict the risk of cardiac mortality in breast cancer patients. Acta Oncol 2016;55(12):1506-1510.
• 10.Marks LB, Bentzen SM, Deasy JO, et al. Radiation dose-volume effects in the lung. Int J Radiat Oncol Biol Phys 2010;76(3 Suppl):S70-76.
• 11.Jo IY, Kay CS, Kim JY, et al. Significance of low-dose radiation distribution in development of radiation pneumonitis after helical-tomotherapy-based hypofractionated radiotherapy for pulmonary metastases. J Radiat Res 2014;55(1):105-112.
• 12.Zhao H, He M, Cheng G, et al. A comparative dosimetric study of left sided breast cancer after breast-conserving surgery treated with VMAT and IMRT. Radiat Oncol 2015;10:231.
• 13.Hodapp N. [The ICRU Report 83: prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT)]. Strahlenther Onkol 2012;188(1):97-99.
• 14.Merzenich H, Bartkowiak D, Schmidberger H, et al. 3D conformal radiotherapy is not associated with the long-term cardiac mortality in breast cancer patients: a retrospective cohort study in Germany (PASSOS-Heart Study). Breast Cancer Res Treat 2017;161(1):143-152.
• 15.Mousavi N, Nohria A. Radiation-induced cardiovascular disease. Curr Treat Options Cardiovasc Med 2013;15(5):507-517.
• 16.Darby SC, Ewertz M, McGale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 2013;368(11):987-998.
• 17.Beaton L, Bergman A, Nichol A, et al. Cardiac death after breast radiotherapy and the QUANTEC cardiac guidelines. Clin Transl Radiat Oncol 2019;19:39-45.
• 18.Kahan Z, Csenki M, Varga Z, et al. The risk of early and late lung sequelae after conformal radiotherapy in breast cancer patients. Int J Radiat Oncol Biol Phys 2007;68(3):673-681.
• 19.Mulliez T, Speleers B, Madani I, De Gersem W, Veldeman L, De Neve W. Whole breast radiotherapy in prone and supine position: is there a place for multi-beam IMRT? Radiat Oncol 2013;8:151.
• 20.Sethi RA, No HS, Jozsef G, Ko JP, Formenti SC. Comparison of three-dimensional versus intensity-modulated radiotherapy techniques to treat breast and axillary level III and supraclavicular nodes in a prone versus supine position. Radiother Oncol 2012;102(1):74-81.
• 21.Stovall M, Smith SA, Langholz BM, et al. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study. Int J Radiat Oncol Biol Phys 2008;72(4):1021-1030.
• 22.Taylor JM, Song A, Nowak K, et al. Dosimetric Comparisons of Simulation Techniques for Left-Sided Breast Cancer in the COVID-19 Era: Techniques to Reduce Viral Transmission and Respect the Therapeutic Ratio. Cureus 2021;13(2).
• 23.Yu T,Xu M,Sun T,et al. External-beam Partial Breast Irradiation in a Supine versus Prone Position after Breast-conserving Surgery for Chinese Breast Cancer Patients.Scientific Reports 2018;8:15354