Long-term clinical outcomes of whole-breast irradiation delivered in the prone position Journal Article
| Authors: | Stegman, L. D.; Beal, K. P.; Hunt, M. A.; Fornier, M. N.; McCormick, B. |
| Article 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 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. © 2007 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; retrospective studies; major clinical study; overall survival; cancer recurrence; doxorubicin; fluorouracil; skin toxicity; cancer radiotherapy; disease free survival; chemotherapy; methotrexate; outcome assessment; follow up; follow-up studies; edema; metastasis; neoplasm recurrence, local; breast cancer; radiotherapy; aromatase inhibitor; cyclophosphamide; radiation injury; breast neoplasms; oncology; retrospective study; cancer invasion; thorax pain; evaluation; tumors; radiation dose fractionation; adjuvant chemotherapy; partial mastectomy; irradiation; tamoxifen; dermatitis; toxicity; disease control; body posture; patient positioning; radiation field; thorax wall; biological organs; diseases; breast conservation therapy; mastectomy, segmental; hormones; optimization; breast tangents; breast techniques; prone position |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 68 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2007-05-01 |
| Start Page: | 73 |
| End Page: | 81 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2006.11.054 |
| PUBMED: | 17337131 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 16" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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