Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Gent, Belgium.
Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Gent, Belgium.
Sci Rep. 2020 Oct 2;10(1):16376. doi: 10.1038/s41598-020-72702-3.
Prone positioning for whole-breast irradiation (WBI) reduces dose to organs at risk, but reduces set-up speed, precision, and comfort. We aimed to improve these problems by placing patients in prone crawl position on a newly developed crawl couch (CrC). A group of 10 right-sided breast cancer patients requiring WBI were randomized in this cross-over trial, comparing the CrC to a standard prone breastboard (BB). Laterolateral (LL), craniocaudal (CC) and anterioposterior (AP) set-up errors were evaluated with cone beam CT. Comfort, preference and set-up time (SUT) were assessed. Forty left and right-sided breast cancer patients served as a validation group. For BB versus CrC, AP, LL and CC mean patient shifts were - 0.8 ± 2.8, 0.2 ± 11.7 and - 0.6 ± 4.4 versus - 0.2 ± 3.3, - 0.8 ± 2.5 and - 1.9 ± 5.7 mm. LL shift spread was reduced significantly. Nine out of 10 patients preferred the CrC. SUT did not differ significantly. The validation group had mean patient shifts of 1.7 ± 2.9 (AP), 0.2 ± 3.6 (LL) and - 0.2 ± 3.3 (CC) mm. Mean SUT in the validation group was 1 min longer (P < 0.05) than the comparative group. Median SUT was 3 min in all groups. The CrC improved precision and comfort compared to BB. Set-up errors compare favourably to other prone-WBI trials and rival supine positioning.
俯卧位全乳放疗（WBI）可降低危及器官的剂量，但会降低摆位速度、精度和舒适度。我们旨在通过让患者俯卧在新开发的爬行椅（CrC）上来改善这些问题。在这项交叉试验中，我们将 10 名右侧乳腺癌患者随机分为两组，分别使用 CrC 和标准俯卧乳房板（BB）进行比较。使用锥形束 CT 评估后外侧（LL）、颅尾（CC）和前后（AP）的摆位误差。评估舒适度、偏好和摆位时间（SUT）。40 名左侧和右侧乳腺癌患者作为验证组。对于 BB 与 CrC，AP、LL 和 CC 患者平均移位分别为-0.8 ± 2.8、0.2 ± 11.7 和-0.6 ± 4.4 与-0.2 ± 3.3、-0.8 ± 2.5 和-1.9 ± 5.7 mm。LL 移位范围显著减小。10 名患者中有 9 名更喜欢 CrC。SUT 无显著差异。验证组的患者平均移位为 1.7 ± 2.9（AP）、0.2 ± 3.6（LL）和-0.2 ± 3.3（CC）mm。验证组的平均 SUT 比比较组长 1 分钟（P < 0.05）。所有组的中位数 SUT 均为 3 分钟。CrC 与 BB 相比，提高了精度和舒适度。摆位误差与其他俯卧 WBI 试验相当，与仰卧位相当。
