ArticleJournal of applied clinical medical physics2022
Four irradiation and three positioning techniques for whole-breast radiotherapy: Is sophisticated always better?
Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Alternative Treatment Positions over Supine in Adjuvant Whole Breast RT: Prone, Lateral or What Else? A Comprehensive Narrative Review.Journal of personalized medicine · 2026Review
- The Prone-Position Whole Breast Irradiation Paradox: Where Do We Stand? A Comprehensive Review.Journal of clinical medicine · 2026Review
- Correlations between patient-specific parameters and dosimetric indices for personalized breast cancer radiotherapy.Scientific reports · 2024Article
- Four irradiation and three positioning techniques for whole-breast radiotherapy: Is sophisticated always better?Journal of applied clinical medical physics · 2022Article
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
purposeWe report on a dosimetrical study of three patient positions (supine, prone dive, and prone crawl) and four irradiation techniques for whole-breast irradiation (WBI): wedged-tangential fields (W-TF), tangential-field intensity-modulated radiotherapy (TF-IMRT), multi-beam IMRT (MB-IMRT), and intensity-modulated arc therapy (IMAT). This is the first study to evaluate prone crawl positioning in WBI and the first study to quantify dosimetrical and anatomical differences with prone dive positioning.
methodsWe analyzed five datasets with left- and right-sided patients (n = 51). One dataset also included deep-inspiration breath hold (DIBH) data. A total of 252 new treatment plans were composed. Dose-volume parameters and indices of conformity were calculated for the planning target volume (PTV) and organs-at-risk (OARs). Furthermore, anatomical differences among patient positions were quantified to explain dosimetrical differences.
resultsTarget coverage was inferior for W-TF and supine position. W-TF proved overall inferior, and IMAT proved foremost effective in supine position. TF-IMRT proved competitive to the more demanding MB-IMRT and IMAT in prone dive, but not in prone crawl position. The lung-sparing effect was overall confirmed for both prone dive and prone crawl positioning and was largest for prone crawl. For the heart, no differences were found between prone dive and supine positioning, whereas prone crawl showed cardiac advantages, although minor compared to the established heart-sparing effect of DIBH. Dose differences for contralateral breast were minor among the patient positions. In prone crawl position, the ipsilateral breast sags deeper and the PTV is further away from the OARs than in prone dive position.
conclusionsThe prone dive and prone crawl position are valid alternatives to the supine position in WBI, with largest advantages for lung structures. For the heart, differences are small, which establishes the role of DIBH in different patient positions. These results may be of particular interest to radiotherapy centers with limited technical resources.
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