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Table 5 Comparison of published series of prone position for breast radiotherapy

From: Prospective study of postoperative whole breast radiotherapy for Japanese large-breasted women: a clinical and dosimetric comparisons between supine and prone positions and a dose measurement using a breast phantom

References Year Number Study objectives Inclusion criteria Observated results
Merchant et al. [10] 1994 56 Prone whole breast iradiation Breast irradiation Improve dose homogeneity of the breast
Grann et al. [19] 2000 56 Prone whole breast iradiation Large or pendulous breast Improve dose homogeneity of the breast.
Eighty percent of patients experienced Grade I or Grade II erythema.
Mahe et al. [20] 2002 35 Prone whole breast iradiation Large and/or pendulous breast The high-dose regions of the base and the top of the breast did not exceed 105 %. Only G1-2 acute dermatitis was observed.
Griem et al. [8] 2003 15 Planning comparison prone vs. supine Breast irradiation Improve dose homogeneity with the prone position.
Significant improve lung DVH, no differences for heart.
Formenti et al. [7] 2004 50 Partial breast irradiation in prone Postmenopausal T1N0 Good lung and heart DVH
Buijsen et al. [6] 2007 10 Planning comparison prone vs. supine Pendulous breasts (bra sizeD and over) Improve dose homogeneity and lung DVH with the prone position
Stegman et al. [29] 2007 245 Prone whole breast iradiation Beams with gantry angles of 90° ± 10°and 270° ± 10° Grade 2–3 acute dermatitis were limited to 18 %.
Grade 2, Grade 3, and Grade 4 chronic dermatitis was seen in 27.8, 2.8, and 1.6 %.
Varga et al. [11] 2009 61 Planning comparison prone vs. supine Breast irradiation Significant improve lung DVH, no differences for heart.
Kirby et al. [24] 2010 65 Planning comparison prone vs. supine Partial or total breast irradiation Improve lung DVH; improve heart DVH for big breast
Bergom et al. [21] 2012 110 Prone whole breast iradiation Large body habitus and/or large-pendulous breasts Excellent to good cosmesis was achieved in 89 %. G3 acute dermatitis in 5 %.
Lymberis et al. [25] 2012 100 Planning comparison prone vs. supine (3DCRT or IMRT) Breast irradiation Improve lung and heart DVH with the prone position
Formenti et al. [26] 2012 200 Planning comparison prone vs. supine Breast irradiation Reduction in the amount of irradiated lung in all patients and in the amount of heart volume irradiated in 85 % of patients with left breast cancer.
Mulliez et al. [22] 2013 100 Comparing prone and supine setup of hypo-fractionated IMRT European cup size C or more Improve dose coverage, better homogeneity, less volumes of over-dosage with the prone position
  1. DVH dose volume histograms, 3DCRT Three-dimensional conformal radiation therapy, IMRT Intensity Modulated Radiation Therapy