Comparison of Dosimetric Parameters of Patient with Large and Pendulous Breast Receiving Breast Radiotherapy in the Prone versus Supine Position

Sun Young Moon; Myonggeun Yoon; Weon Kuu Chung; Mijoo Chung; Dong Oh Shin; Dong Wook Kim

doi:10.14316/pmp.2015.26.4.234

Journal List > Prog Med Phys > v.26(4) > 1098487

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Moon, Yoon, Chung, Chung, Shin, and Kim: Comparison of Dosimetric Parameters of Patient with Large and Pendulous Breast Receiving Breast Radiotherapy in the Prone versus Supine Position

Original Article

Progress in Medical Physics 2015;26(4):234-240.

Published online: 20 January 2015

DOI: https://doi.org/10.14316/pmp.2015.26.4.234

Comparison of Dosimetric Parameters of Patient with Large and Pendulous Breast Receiving Breast Radiotherapy in the Prone versus Supine Position

Sun Young Moon^∗, Myonggeun Yoon^∗, Weon Kuu Chung^†, Mijoo Chung^†, Dong Oh Shin^‡, Dong Wook Kim^†

^∗Department of Bio-convergence Engineering, Korea University, Seoul, Korea

^†Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea

^‡Department of Radiation Oncology, Kyung Hee University Hospital, Seoul, Korea

Correspondence: Dong Wook Kim (joocheck@gmail.com) Tel: 82-2-440-6071, Fax: 82-2-440-7390 cc This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received 1 December 2015 Revised 18 December 2015 Accepted 19 December 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study is to analyze dosimetric parameters of patient with large and pendulous breast receiving breast radiotherapy in the prone versus supine position. The patient underwent computed tomography simulation in both prone and supine position. The homogeneity index (HI), conformity index (CI), coverage index (CVI) to the left breast as planning target volume (PTV) and the doses to the lung, heart, and right breast as organ at risk (OAR) were compared by using dose-volume histogram. The lifetime attributable risk (LAR) according to the prone and supine position was measured for the lung and right breast. The HI, CI of the PTV decreased 21.7%, 6.49%, respectively and the CVI increased 10.8% with the prone position. The mean and maximum dose to the left lung decreased 91.6%, 87.0%, respectively and the volume parameters also decreased over 99% with the prone position. The parameters to the right lung were same regardless of the position. The mean and maximum dose to the heart decreased 51.6%, 14.2% with the prone position. But the mean and maximum dose to the right breast increased unlike the other OARs. The LARs to the lung decreased 80.3% (left), 24.2% (right) but the LAR to the right breast doubled with the prone position. The prone position is a favorable alternative for irradiation of breast in patients with large and pendulous breasts.

Keywords: Large breast, Breast cancer, Prone position, Radiotherapy

References

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Fig. 1.

Dose-volume histogram of the patient; (a) Prone (b) Supine. PTV: red, right lung: blue, left lung: bluish green, right breast: green, heart: plum.

Fig. 2.

CT image of the patient; (a) Prone (b) Supine.

Table 1.

HI, CI, CVI of the left breast according to the patient's position.

	HI	CI	CVI
Prone	16.41	0.72	0.92
Supine	20.96	0.77	0.83

Table 2.

Parameters of the OAR according to the patient's position.

Organ	Parameter	Prone	Supine
Left lung	Mean dose (%)	0.7	8.3
	Max dose (%)	12.7	97.5
	V5 (%)	0.16	24.07
	V10 (%)	0.02	14.04
	V20 (%)	0	8.53
Right lung	Mean dose (%)	0.1	0.1
	Max dose (%)	1.3	1.3
	V5 (%)	0	0
	V10 (%)	0	0
	V20 (%)	0	0
Heart	Max dose (%)	83	96.7
	Mean dose (%)	3	6.2
	Mean dose (Gy)	1.51	3.12
	Dysfunction R(%)	10.58	21.87
Right breast	Mean dose (%)	0.4	0.2
	Max dose (%)	19.1	15.9

Table 3.

LAR of the OAR according to the patient's position.

Organ	LA Prone	AR Supine
Left lung	205	1,043
Right lung	25	33
Right breast	55	28

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