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Radiotherapy after breast conserving therapy plays an important role in early stage breast cancer patients. It not only results in a reduction in local and regional recurrence but also decrease the death rate effectively. For adjuvant radiotherapy, supine positioning is the most common approach and has multiple advantages. Due to deformability and softness of the breast, during simulation and treatment in supine position, the breast stretches over the chest wall, especially in patients with large and pendulous glands. Thus the organs at risk (OARs) received dose increased. The radiotherapeutic toxicity are unavoidable. Some present studies show that the prone positioning of patients can improve dose homogeneity and reduce the dose distribution in OARs in patients with large and pendulous glands. Chinese women have relatively small breasts, the advantages of those have not been established. Therefore, investigators compared the parameters between supine and prone positions for whole breast irradiation after conserving surgery.
Objective To investigate the difference of target volumes and dosimetric parameters between supine and prone positions for whole breast irradiation after conserving surgery.
Methods Breast cancer patients with T1-2N0M0 stage who underwent radiation therapy after conserving surgery were enrolled. 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 whole breast. The planning target volume (PTV) was CTV plus 0.5cm. The boost of PTV (PTVboost) was TB plus 0.5cm. Dosimetric parameters of target volumes and OARs were compared between supine and prone position.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Breast cancer underwent scanning in the supine position | Experimental | Breast cancer patients with T1-2N0M0 stage who underwent radiation therapy after conserving surgery were enrolled. Supine 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 whole breast. The planning target volume (PTV) was CTV plus 0.5cm. The boost of PTV (PTVboost) was TB plus 0.5cm. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| dedicated treatment board with no degree | Device | the patients were placed in the prone position on a dedicated treatment board with no degree incline using an arm support (with both arms above the head). Te board contained an open aperture on one side to allow for the ipsilateral breast to hang freely away from the chest wall |
| Measure | Description | Time Frame |
|---|---|---|
| dose distribution of GTV | the difference of GTV (Gross tumor target) between two plans | 1 year |
| dose distribution of CTV | the difference of CTV (clinical target volume) between two plans | 1 year |
| dose distribution of PTV | the difference of PTV (planing target volume) between two plans | 1 year |
| dose distribution of heart | the difference of heart dose distribution between two plans | 1 year |
| dose distribution of ipsilateral lung | the difference of ipsilateral lung dose distribution between two plans | 1 year |
| dose distribution of bilateral breasts | the difference of bilateral breasts dose distribution between two plans | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ning Li | Contact | 13521952929 | liningnci@126.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanxi provicial cancer hospital | Recruiting | Taiyuan | Shanxi | 030001 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41572204 | Derived | Feng L, Liang Y, Huang J, Xu S, Zhang W, Su X, Tan Y, Lei T, Xiang X, Chen L, Lei J, Hu N, Jin J, Xiao Q, Li N. Evaluation of organs at risk (OARs) in whole-breast irradiation: a comparison of prone, supine position and with deep inspiration breath-hold techniques-subgroup analysis from a prospective study. BMC Cancer. 2026 Jan 22;26(1):307. doi: 10.1186/s12885-025-15445-6. | |
| 37946125 |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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Breast cancer patients with T1-T2N0M0 stage who underwent radiation therapy after conserving surgery were enrolled. 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.
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|
| Derived |
| Ma L, Yang Y, Ma J, Mao L, Li X, Feng L, Abulimiti M, Xiang X, Fu F, Tan Y, Zhang W, Li YX, Jin J, Li N. Correlation between AI-based CT organ features and normal lung dose in adjuvant radiotherapy following breast-conserving surgery: a multicenter prospective study. BMC Cancer. 2023 Nov 9;23(1):1085. doi: 10.1186/s12885-023-11554-2. |
| D017437 |
| Skin and Connective Tissue Diseases |