Scientific article
OA Policy
English

Prone versus supine free-breathing for right-sided whole breast radiotherapy

Published inScientific reports, vol. 12, no. 1, 525
First online date2022-01-11
Abstract

Prone setup has been advocated to improve organ sparing in whole breast radiotherapy without impairing breast coverage. We evaluate the dosimetric advantage of prone setup for the right breast and look for predictors of the gain. Right breast cancer patients treated in 2010-2013 who had a dual supine and prone planning were retrospectively identified. A penalty score was computed from the mean absolute dose deviation to heart, lungs, breasts, and tumor bed for each patient's supine and prone plan. Dosimetric advantage of prone was assessed by the reduction of penalty score from supine to prone. The effect of patients' characteristics on the reduction of penalty was analyzed using robust linear regression. A total of 146 patients with right breast dual plans were identified. Prone compared to supine reduced the penalty score in 119 patients (81.5%). Lung doses were reduced by 70.8%, from 4.8 Gy supine to 1.4 Gy prone. Among patient's characteristics, the only significant predictors were the breast volumes, but no cutoff could identify when prone would be less advantageous than supine. Prone was associated with a dosimetric advantage in most patients. It sets a benchmark of achievable lung dose reduction.Trial registration: ClinicalTrials.gov NCT02237469, HUGProne, September 11, 2014, retrospectively registered.

Keywords
  • Adult
  • Aged
  • Breast / radiation effects
  • Breast Neoplasms / radiotherapy
  • Female
  • Humans
  • Lung / radiation effects
  • Middle Aged
  • Organs at Risk / radiation effects
  • Patient Positioning / methods
  • Prone Position
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Respiration
  • Retrospective Studies
  • Supine Position
Citation (ISO format)
FARGIER-BOCHATON, Odile Brigitte Pascale et al. Prone versus supine free-breathing for right-sided whole breast radiotherapy. In: Scientific reports, 2022, vol. 12, n° 1, p. 525. doi: 10.1038/s41598-021-04385-3
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Article (Published version)
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Additional URL for this publicationhttps://www.nature.com/articles/s41598-021-04385-3
Journal ISSN2045-2322
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4downloads

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