The aim of this study was to evaluate retrospectively the planned dose distribution and acute toxicity of adjuvant hypofractionated whole breast radiotherapy (RT) delivered in the prone vs. supine position.
Twenty-four patients were enrolled; 12 underwent adjuvant RT with a supine setup and 12 with a prone setup. We included patients according to breast volume (≥500 mL), disease stage (≤pT2/pN1), and clinical/biological features. Patients received a regimen of 35 Gy in 10 fractions for 2.5 weeks, and a concomitant boost of 3/4 Gy in 1 fraction/week. Target coverage was assessed by volume, V90, V95, V100, V103 and V105. Heart, LADCA and ipsilateral lung doses were evaluated according to volume, maximum dose, mean dose, V14, V10 and V5. We evaluated acute skin toxicity during RT, at the end of treatment, and after 1 month according to RTOG scales.
Radiobiological equivalence was warranted with satisfactory BED values: considering α/β = 4 for breast cancer, the 10-fraction schedule equaled 74 or 77 Gy depending on the boost dose (3 Gy vs. 4 Gy, respectively). Toxicity was low and similar for supine and prone treatments. Dose sparing was significant in the ipsilateral lung in the prone position (median Dmax: 28.7 Gy vs. 38.4 Gy; median Dmean: 0.8 Gy vs. 6.3 Gy; median V14: 0.6% vs. 13.5%; median V5: 0 vs. 19.3%, p<0.001).
This novel 10-fraction schedule is feasible and well tolerated; the prone position allows better saving of OARs, with a statistically significant value for the ipsilateral lung.
Tumori 2015; 101(2): 154 - 160
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsMarina Guenzi, Davide Bosetti, Giorgio Lamanna, Guido Siffredi, Elisabetta Bonzano, Marco Gusinu, Stefania Garelli, Francesco Pupillo, Renzo Corvò
- • Accepted on 09/10/2014
- • Available online on 02/04/2015
- • Published in print on 28/04/2015
This article is available as full text PDF.
- Guenzi, Marina [PubMed] [Google Scholar] 1
- Bosetti, Davide [PubMed] [Google Scholar] 2
- Lamanna, Giorgio [PubMed] [Google Scholar] 2, * Corresponding Author (email@example.com)
- Siffredi, Guido [PubMed] [Google Scholar] 2
- Bonzano, Elisabetta [PubMed] [Google Scholar] 2
- Gusinu, Marco [PubMed] [Google Scholar] 3
- Garelli, Stefania [PubMed] [Google Scholar] 3
- Pupillo, Francesco [PubMed] [Google Scholar] 2
- Corvò, Renzo [PubMed] [Google Scholar] 1, 2
Department of Radiation Oncology, IRCCS San Martino-IST, National Cancer Research Institute, Genoa - Italy
University of Genoa, DISSAL, Genoa - Italy
Department of Medical Physics, IRCCS San Martino-IST, National Cancer Research Institute, Genoa - Italy