Comparison of supine or prone crawl photon or proton breast and regional lymph node radiation therapy including the internal mammary chain.

Speleers, Bruno A; Belosi, Francesca M; De Gersem, Werner R; Deseyne, Pieter R; Paelinck, Leen M; Bolsi, Alessandra; Lomax, Antony J; Boute, Bert G; Van Greveling, Annick E; Monten, Christel M; Van de Velde, Joris J; Vercauteren, Tom H; Veldeman, Liv; Weber, Damien C.; De Neve, Wilfried C (2019). Comparison of supine or prone crawl photon or proton breast and regional lymph node radiation therapy including the internal mammary chain. Scientific reports, 9(1), p. 4755. Springer Nature 10.1038/s41598-019-41283-1

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We report on a dosimetrical study comparing supine (S) and prone-crawl (P) position for radiotherapy of whole breast (WB) and loco-regional lymph node regions, including the internal mammary chain (LN_IM). Six left sided breast cancer patients were CT-simulated in S and P positions and four patients only in P position. Treatment plans were made using non-coplanar volumetric modulated arc photon therapy (VMAT) or pencil beam scanning intensity modulated proton therapy (IMPT). Dose prescription was 15*2.67 Gy(GyRBE). The average mean heart doses for S or P VMAT were 5.6 or 4.3 Gy, respectively (p = 0.16) and 1.02 or 1.08 GyRBE, respectively for IMPT (p = 0.8; p < 0.001 for IMPT versus VMAT). The average mean lung doses for S or P VMAT were 5.91 or 2.90 Gy, respectively (p = 0.002) and 1.56 or 1.09 GyRBE, respectively for IMPT (p = 0.016). In high-risk patients, average (range) thirty-year mortality rates from radiotherapy-related cardiac injury and lung cancer were estimated at 6.8(5.4-9.4)% or 3.8(2.8-5.1)% for S or P VMAT (p < 0.001), respectively, and 1.6(1.1-2.0)% or 1.2(0.8-1.6)% for S or P IMPT (p = 0.25), respectively. Radiation-related mortality risk could outweigh the ~8% disease-specific survival benefit of WB + LN_IM radiotherapy for S VMAT but not P VMAT. IMPT carries the lowest radiation-related mortality risks.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Weber, Damien Charles

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2045-2322

Publisher:

Springer Nature

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

05 Nov 2019 17:04

Last Modified:

10 Nov 2019 02:46

Publisher DOI:

10.1038/s41598-019-41283-1

PubMed ID:

30894606

BORIS DOI:

10.7892/boris.134609

URI:

https://boris.unibe.ch/id/eprint/134609

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