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001-es BibID:	BIBFORM065768
Első szerző:	Lakosi Ferenc
Cím:	Respiratory Motion, Anterior Heart Displacement and Heart Dosimetry : Comparison Between Prone (Pr) and Supine (Su) Whole Breast Irradiation / Ferenc Lakosi, Akos Gulyban, Levente Janvary, Selma Ben-Mustapha Simoni, Nicolas Jansen, Laurence Seidel, Arpad Kovacs, Peter Vavassis, Philippe Coucke,
Dátum:	2015
ISSN:	1219-4956 1532-2807
Megjegyzések:	Abstract: To analyze respiratory motion of surgical clips,chest wall (CW) and the anterior displacement of the heartand its impact on heart dosimetry between prone (Pr) andsupine (Su) positions during whole breast radiotherapy afterbreast conserving surgery. Sixteen patients underwent 4D-CTfor radiotherapy planning in Pr and Su positions. Maximuminhale and maximum exhale phases were analyzed. Mean 3Dvectorial displacements?standard deviations (SD) of the surgical clips were measured. Volumetric changes of the CWwere recorded and compared. Cardiac displacement wasassessed by a volume between the inner surface of CW andthe myocardium of the heart (CW/H-V). For left-sided cases,comparative dosimetry was performed in each position simulating no- (Pr-noC, Su-noC) versus daily correction protocols (Pr-C, Su-C). The movements of 81 surgical clips were analyzed. Prone positioning significantly reduced both the mean 3D vectorial displacements (1.1?0.6 (Pr) vs. 2.0?0.9 mm (Su), p<0.01) and their variability (0.3?0.2 vs. 0.5?0.3 mm,p=0.01). Respiration-induced volumetric changes of CW were also significantly lower in Pr (2.3?4.9 vs. 9.6?7.1 cm3 , p<0.01). The CW/H-V was significantly smaller inPr than in Su (39.9?14.6 vs. 64.3?28.2 cm3 , p<0.01). Besides identical target coverage heart, left-anterior-descending coronary artery (LADCA) and ipsilateral lung dose parameters were lowered with Pr-C compared to Pr-noC, Su-C and Su-noC. Prone position significantly reduced respiration related surgical clip movements, their variability as well as CW movements. Significant anterior heart displacement wasobserved in Pr. Prone position with daily online correctioncould maximize the heart and LADCA protection.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény hazai lapban Breast cancer Prone breast radiotherapy 4D-computed tomography Respiratory motion Left-anterior-descending coronary artery
Megjelenés:	Pathology & Oncology Research 21 : 4 (2015), p. 1051-1058. -
További szerzők:	Gulybán Ákos (Pécs) Jánváry Zsolt Levente (1977-) (orvos) Simoni, Selma Ben-Mustapha Jansen, Nicolas Seidel, Laurence Kovács Árpád (1979-) (onkoradiológus, klinikai onkológus) Vavassis, Peter Coucke, Philippe A.
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