Prog Med Phys.  2015 Dec;26(4):234-240. 10.14316/pmp.2015.26.4.234.

Comparison of Dosimetric Parameters of Patient with Large and Pendulous Breast Receiving Breast Radiotherapy in the Prone versus Supine Position

Affiliations
  • 1Department of Bio-convergence Engineering, Korea University, Korea.
  • 2Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Korea. joocheck@gmail.com
  • 3Department of Radiation Oncology, Kyung Hee University Hospital, Seoul, Korea.

Abstract

The purpose of this study is to analyze dosimetric parameters of patient with large and pendulous breast receiving breast radiotherapy in the prone versus supine position. The patient underwent computed tomography simulation in both prone and supine position. The homogeneity index (HI), conformity index (CI), coverage index (CVI) to the left breast as planning target volume (PTV) and the doses to the lung, heart, and right breast as organ at risk (OAR) were compared by using dose-volume histogram. The lifetime attributable risk (LAR) according to the prone and supine position was measured for the lung and right breast. The HI, CI of the PTV decreased 21.7%, 6.49%, respectively and the CVI increased 10.8% with the prone position. The mean and maximum dose to the left lung decreased 91.6%, 87.0%, respectively and the volume parameters also decreased over 99% with the prone position. The parameters to the right lung were same regardless of the position. The mean and maximum dose to the heart decreased 51.6%, 14.2% with the prone position. But the mean and maximum dose to the right breast increased unlike the other OARs. The LARs to the lung decreased 80.3% (left), 24.2% (right) but the LAR to the right breast doubled with the prone position. The prone position is a favorable alternative for irradiation of breast in patients with large and pendulous breasts.

Keyword

Large breast; Breast cancer; Prone position; Radiotherapy

MeSH Terms

Breast Neoplasms
Breast*
Heart
Humans
Lung
Prone Position
Radiotherapy*
Supine Position*

Figure

  • Fig. 1. Dose-volume histogram of the patient; (a) Prone (b) Supine. PTV: red, right lung: blue, left lung: bluish green, right breast: green, heart: plum.

  • Fig. 2. CT image of the patient; (a) Prone (b) Supine.


Reference

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