Potential advantages of crawl place for susceptible radiation remedy in breast most cancers.
J Appl Clin Med Phys. 2017 Jul;18(four):200-205
Authors: Boute B, De Neve W, Speleers B, Van Greveling A, Monten C, Van Hoof T, Van de Velde J, Paelinck L, De Gersem W, Vercauteren T, Detand J, Veldeman L
PURPOSE: To analyze crawl place with the arm on the handled aspect alongside the physique and on the reverse aspect above the top for susceptible remedy in sufferers requiring breast and regional lymph node irradiation.
METHODS: Affected person assist gadgets for crawl place have been constructed for CT simulation and remedy. An uneven fork design resulted from an iterative strategy of prototype building and testing. The fork’s massive horn helps the hemi-thorax, shoulder, and elevated arm on the nontreated aspect and the top. The quick, slim horn helps the arm on the handled aspect. Between each horns, the handled breast and its regional lymph nodes are uncovered. Endpoints have been ache, consolation, set-up precision, beam entry to the breast and lymph nodes, and plan dose metrics. Ache and luxury have been examined by volunteers (n = 9); set-up precision, beam entry, and plan dose metrics have been examined by way of a affected person research (n = 10). The AIO™ (Orfit, Wijnegem, Belgium) susceptible breastboard (AIO™) was used as a reference concerning consolation and set-up precision.
RESULTS: Ache on the sternum, the ipsilateral shoulder, higher arm, and neck was decrease in crawl place than with bilateral arm elevation on AIO™. Consolation and set-up precision have been higher on the crawl prototype than on AIO™. In crawl place, beam instructions within the coronal and near-sagittal planes have entry to the breast or regional lymph nodes with out traversing system elements. Plan comparability between supine and crawl positions confirmed higher dose homogeneity for the breast and lymph node targets and dose reductions to all organs in danger for crawl place.
CONCLUSIONS: Radiation remedy for breast and regional lymph nodes in crawl place is possible. Good consolation and set-up precision have been demonstrated. Planning outcomes assist the speculation that breast and regional lymph nodes will be handled in crawl place with much less dose to organs in danger and equal or higher dose distribution within the goal volumes than in supine place. The crawl method is a candidate methodology for additional investigation for sufferers requiring breast and regional lymph node irradiation.
PMID: 28649708 [PubMed – indexed for MEDLINE]