skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

Abstract

Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneousmore » tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose.« less

Authors:
 [1];  [1];  [2];  [3];  [4]
  1. Department of Radiation Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  2. Department of Medical Physics, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  3. Department of Breast Cancer Medicine Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  4. Department of Radiation Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States). E-mail: mccormib@mskcc.org
Publication Date:
OSTI Identifier:
20951617
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.11.054; PII: S0360-3016(06)03662-5; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; CHEST; DERMATITIS; EDEMA; FRACTIONATED IRRADIATION; HORMONES; LUNGS; MAMMARY GLANDS; METASTASES; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SKIN; TOXICITY; WOMEN

Citation Formats

Stegman, Lauren D., Beal, Katherine P., Hunt, Margie A., Fornier, Monica N., and McCormick, Beryl. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.11.054.
Stegman, Lauren D., Beal, Katherine P., Hunt, Margie A., Fornier, Monica N., & McCormick, Beryl. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position. United States. doi:10.1016/j.ijrobp.2006.11.054.
Stegman, Lauren D., Beal, Katherine P., Hunt, Margie A., Fornier, Monica N., and McCormick, Beryl. Tue . "Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position". United States. doi:10.1016/j.ijrobp.2006.11.054.
@article{osti_20951617,
title = {Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position},
author = {Stegman, Lauren D. and Beal, Katherine P. and Hunt, Margie A. and Fornier, Monica N. and McCormick, Beryl},
abstractNote = {Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose.},
doi = {10.1016/j.ijrobp.2006.11.054},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 68,
place = {United States},
year = {Tue May 01 00:00:00 EDT 2007},
month = {Tue May 01 00:00:00 EDT 2007}
}