A comparison of the target volume and dosimetric variance between supine and prone positions for external-beam partial breast irradiation after breast-conserving surgery
10.3760/cma.j.issn.0254-5098.2018.02.003
- VernacularTitle:保乳术后仰卧位与俯卧位部分乳腺外照射靶区体积及剂量学比较
- Author:
Ting YU
1
;
Wei WANG
;
Min XU
;
Tao SUN
;
Qian SHAO
;
Yingjie ZHANG
;
Xijun LIU
;
Fengxiang LI
;
Jianbin LI
Author Information
1. 250022,济南大学 山东省医学科学院医学与生命科学学院
- Keywords:
Post breast-conserving surgery;
External-beam irradiation;
Position;
Target volume;
Dose
- From:
Chinese Journal of Radiological Medicine and Protection
2018;38(2):93-99
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the difference of target volumes and dosimetric parameters between supine and prone positions for external-beam partial breast irradiation (EB-PBI) after breastconserving surgery (BCS).Methods Thirty breast cancer patients with T1N0M0 stage who underwent three-dimensional conformal radiation therapy (3D-CRT) EB-PBI after BCS were enrolled from July 2016 to April 2017.Supine and prone scan sets were acquired during free breathing for all patients.Target volumes and organs at risk (OARs) including heart,ipsilateral lung and bilateral breast were contoured by the same radiation oncologist.The tumor bed (TB) was determined based on surgical clips.The clinical target volume (CTV) consisted of the TB plus 1.0 cm margin and the planning target volume (PTV) was CTV plus 0.5 cm.Dosimetric parameters for target volumes and OARs were compared between supine and prone positions.Results The median volumes of the TB,the CTV and the PTV in supine were 14.40 cm3,57.35 cm3,108.85 cm3 and 14.10 cm3,62.60 cm3,113.70 cm3 for prone positions,respectively.The CTV and PTV in prone position were significantly greater than those in supine position,respectively (Z=-3.01,-2.87,P ＜0.05),but the TBs were not statistically different (P ＞0.05).The median homogeneity indexs (HI) in supine position was less than those in prone position (Z =-3.137,P ＜0.05),while the mean conformal indexs (CI) was increased with prone positioning (t =9.034,P ＜ 0.05).The mean dose (D) to the heart in the supine position was significantly lower than that in prone (0.34 and 1.19 Gy,Z =-4.12,P ＜0.05).The D to the ipsilateral lung in the prone position was significantly lower than that in supine (1.59 and 1.72 Gy,Z =-2.18,P ＜ 0.05).There was not significantly statistical difference for the D to the ipsilateral breast between two positionings (10.01 and 10.40 Gy,P ＞0.05).Conclusions It was feasible to carry out 3D-CRT EB-PBI in prone position in free breathing for Chinese breast cancer patient,with primary advantages of better CI and the significantly lower radiation dose to the ipsilateral lung.
