ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2025
Immune-sparing potential of isocentric lateral decubitus positioning in adjuvant whole-breast radiotherapy.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Alternative Treatment Positions over Supine in Adjuvant Whole Breast RT: Prone, Lateral or What Else? A Comprehensive Narrative Review.Journal of personalized medicine · 2026Review
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3 authors.
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Abstract
backgroundLymphocytes are among the most radiosensitive cell types, and low-dose exposure during radiotherapy has been associated with measurable immune suppression. In breast cancer treatment, systemic immune exposure is partly driven by irradiation of highly vascularized organs such as the heart, lungs, and liver. The axillary lymph nodes also play a critical role in initiating antitumor immune responses. Isocentric lateral decubitus (ILD) positioning, by modifying the beam orientation, may reduce incidental exposure to these immune-related structures. This study aimed to evaluate the potential of ILD to spare both circulating immune cells and axillary lymph nodes compared to standard supine positioning during whole-breast irradiation (WBI).
methodsEight patients with localized breast cancer treated with breast-conserving surgery and adjuvant WBI (without nodal irradiation) were included in this retrospective dosimetric study. Each patient underwent CT simulation and treatment planning in both supine and ILD positions. The estimated dose to circulating immune cells (EDIC) was calculated using a model based on mean doses to the lungs, heart, liver, and whole body. The level I axillary region was retrospectively contoured, and both the mean dose and D95 were extracted. Dosimetric comparisons between positions were performed using paired Wilcoxon signed-rank tests.
resultsIsocentric lateral decubitus positioning significantly reduced the EDIC compared to the supine position (median 0.56 Gy vs. 1.12 Gy; p < 0.01). Lung, heart, and liver doses were also significantly lower. The axillary dose was reduced, with the mean dose decreasing from 10.2 to 3.8 Gy (p = 0.016) and D95% from 0.82 to 0.35 Gy (p = 0.039).
conclusionIsocentric lateral decubitus positioning significantly reduces both systemic and regional immune irradiation during adjuvant WBI. These findings suggest that ILD may help to preserve immune function, particularly in immunogenic subtypes such as triple-negative breast cancer, and support its consideration in treatment planning when nodal irradiation is not indicated.
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