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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