Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium.
Int J Radiat Oncol Biol Phys. 2010 Sep 1;78(1):111-8. doi: 10.1016/j.ijrobp.2009.07.1749.
The aim of this study was to develop a rapid and reproducible technique for prone positioning and to compare dose-volume indices in prone and supine positions.
Eighteen patients underwent computed tomography imaging for radiotherapy planning in prone and supine position. Experience was gained in the first eight patients, which lead to modifications of the Horizon prone breast board (Civco Medical Solutions, Orange City, Iowa, USA) and the patient setup technique. A unilateral breast holder (U-BH) was developed (Van de Velde, Schellebelle, Belgium) to retract the contralateral breast away from the treated breast. The technique was then applied to an additional 10 patients. The setup precision was evaluated using daily cone-beam CT.
Modifications to the breast board were made to secure a prone-lateral rather then a pure prone position. We evolved from a classical setup using laser marks on the patients' body to a direct breast setup using marks on the breast only. The setup precision of the direct positioning procedure with the modified breast board and the U-BH is comparable to supine setup data in the literature. Dose-volume indices for heart and lung show significantly better results for prone than for supine position, and dose homogeneity within the treated breast did not differ according to the treatment position.
The setup precision of our prone-lateral positioning technique is comparable to supine data in literature. Our data show the advantage of prone radiotherapy to spare the lung and heart. Further research is necessary to reduce the duration of prone setup.
本研究旨在开发一种用于俯卧位的快速且可重复的技术，并比较俯卧位和仰卧位的剂量体积指数。
18 名患者接受了放射治疗计划的计算机断层扫描成像，分别处于俯卧位和仰卧位。在前 8 名患者中积累了经验，这导致了 Horizon 俯卧位乳房板（Civco Medical Solutions，爱荷华州奥兰治市，美国）和患者设置技术的修改。开发了单侧乳房固定器（U-BH）（Van de Velde，比利时谢勒贝尔勒），以将对侧乳房从治疗乳房中牵拉出来。然后将该技术应用于另外 10 名患者。使用每日锥形束 CT 评估设置精度。
对乳房板进行了修改，以确保俯卧位而不是纯粹的俯卧位。我们从使用患者身体上的激光标记的经典设置演变为仅使用乳房上的标记的直接乳房设置。带有改良乳房板和 U-BH 的直接定位程序的设置精度与文献中的仰卧位设置数据相当。心脏和肺部的剂量体积指数显示俯卧位明显优于仰卧位，并且治疗乳房内的剂量均匀性与治疗位置无关。
我们的俯卧位侧向定位技术的设置精度与文献中的仰卧位数据相当。我们的数据显示了俯卧放疗对肺和心脏的保护优势。需要进一步研究以减少俯卧位设置的时间。
