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1.
001-es BibID:
BIBFORM065769
Első szerző:
Lakosi Ferenc
Cím:
The Influence of Treatment Position (Prone vs. Supine) on Clip Displacement, Seroma, Tumor Bed and Partial Breast Target Volumes : Comparative Study / Ferenc Lakosi, Akos Gulyban, Selma Ben-Mustapha Simoni, Paul Viet Nguyen, Séverine Cucchiaro, Laurence Seidel, Levente Janvary, Sophie Nicolas, Peter Vavassis, Philippe Coucke
Dátum:
2015
ISSN:
1219-4956 1532-2807
Megjegyzések:
Abstract: To analyse the displacement of surgical clips inprone (Pr) position and assess the consequences on targetvolumes and integral dose of partial breast irradiation (PBI).30 post-lumpectomy breast cancer patients underwent CT imaging in supine (Su) and Pr. Clip displacements were measured by the distances from the clips to a common fix bony reference . On each dataset, the tumour bed (TB = clips ? seroma), clinical target volume (CTV = TB + 1.5 cm) and planning target volumes (PTV = CTV + 1 cm) for PBI weredetermined and the volume pairs were compared. Furthermoreestimation of integral dose ratio (IDR) within the breast from tangential treatment was performed as the ratio of the irradiated breast volume and the volume encompassing all clips.Clips close to the chest wall (CW) in Su showed significantly less displacement in Pr. The mean volumes of seroma, CTV and PTV were significantly higher in Pr than in Su. The PTV volume difference (Pr-Su) was significantly higher in patients with presence of seroma, deep clips and TB location in the superior-internal-quadrant (SIQ) and at the junction of superior quadrants (jSQ). In a multivariate analysis two factors remained significant: seroma and TB localization in SIQjSQ.The IDR was significantly larger in Su than in Pr (7.6 vs. 4.1 p <0.01). Clip displacements varied considerably with respect to their relative position to the CW. In selected patients Pr position potentially leads to a significant increase in target volumes of PBI. Tangential beam arrangement for PBI should be avoided, not only in Su but in Pr as well in case of clipbasedtarget volume definition.
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény hazai lapban
Breast cancer
Prone breast radiotherapy
Partial breast irradiation
Target volume
Megjelenés:
Pathology & Oncology Research 22 : 3 (2015), p. 493-500. -
További szerzők:
Gulybán Ákos (Pécs)
Simoni, Selma Ben-Mustapha
Nguyen, Paul Viet
Cucchiaro, Séverine
Seidel, Laurence
Jánváry Zsolt Levente (1977-) (orvos)
Nicolas, Sophie
Vavassis, Peter
Coucke, Philippe A.
Internet cím:
Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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2.
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.
Internet cím:
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DOI
Intézményi repozitóriumban (DEA) tárolt változat
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