Division of Radiation Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore.
Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore, Singapore.
Strahlenther Onkol. 2024 Apr;200(4):287-295. doi: 10.1007/s00066-023-02131-4. Epub 2023 Sep 2.
A feasibility study to evaluate the Chabner XRT® Radiation Bra (CIVCO Radiotherapy & Qfix, Coralville, IA, USA) as a customised immobilisation device for patients with pendulous breasts undergoing radiotherapy was conducted.
A total of 34 patients with large pendulous breasts were fitted with the Chabner XRT® Radiation Bra during RT. A mixed-method questionnaire was administered to both radiation therapists (RTTs) and patients. RTTs evaluated the effectiveness of the bra in setup. Patients appraised its comfort level and ease of wearing. Setup reproducibility was evaluated based on a departmental imaging protocol. Acute skin side effects were documented with photos and assessed using the Radiation Therapy Oncology Group (RTOG) classification.
Of the patients, 27 (79.4%) completed the questionnaire. 23 patients felt comfortable wearing the bra while 20 felt less exposed during treatment. Reproducibility was acceptable, with a median (range) setup error (isocentre) of 0.0 cm (-0.6 to 0.7 cm; left/right), -0.1 cm (-0.5 to 1.2 cm; posterior) and 0.2 cm (-0.5 to 0.9 cm; inferior) achieved based on matched field borders on skin. However, repeated setups and imaging were required for 3 patients due to large breast size (cups D-G; size 4-5). Minimal skin toxicity (grade 0-1) was observed. No grade ≥ 2 was reported. 10 RTTs completed the survey. Male RTTs (n = 4) were not confident in assisting patients with bra fitting. 8 RTTs agreed that although it was difficult to reproduce the breast tissue for treatment, it helped patients to maintain the treatment position.
Our study demonstrated the feasibility of using a customised bra which provided optimal setup reproducibility while maintaining minimal skin toxicity and patient comfort, especially the value-added modesty felt among Asian women during their breast cancer radiotherapy.
本研究旨在评估 Chabner XRT® Radiation Bra（CIVCO Radiotherapy & Qfix，爱荷华州科勒尔维尔）作为一种定制式固定装置，用于接受放射治疗的乳房下垂患者。
在放射治疗期间，共对 34 例大乳房下垂患者进行了 Chabner XRT® Radiation Bra 适配。我们向放射治疗师（RTT）和患者分发了混合方法调查问卷。RTT 评估了胸罩在摆位中的有效性。患者评估了其舒适度和佩戴便利性。根据部门成像方案评估了摆位重复性。使用照片记录急性皮肤不良反应，并采用放射治疗肿瘤学组（RTOG）分类进行评估。
34 例患者中，有 27 例（79.4%）完成了问卷调查。23 例患者佩戴胸罩感觉舒适，20 例患者在治疗期间感觉暴露度降低。重复性可接受，根据皮肤匹配野边界，获得的中位（范围）摆位误差（等中心）为 0.0cm（-0.6 至 0.7cm；左/右）、-0.1cm（-0.5 至 1.2cm；后）和 0.2cm（-0.5 至 0.9cm；下）。然而，由于乳房较大（罩杯 D-G；大小 4-5），有 3 例患者需要重复摆位和成像。观察到最小的皮肤毒性（0-1 级）。无报告≥2 级。10 名 RTT 完成了调查。4 名男性 RTT 对协助患者适配胸罩没有信心。8 名 RTT 认为，尽管难以复制治疗中的乳房组织，但它有助于患者保持治疗体位。
本研究表明，使用定制胸罩是可行的，这种胸罩可提供最佳的摆位重复性，同时保持最小的皮肤毒性和患者舒适度，特别是在亚洲女性接受乳腺癌放射治疗时，胸罩提供的额外的端庄感。
