Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Lakosi, Ferenc; GULYBAN, Akos; BEN MUSTAPHA, Selma; NGUYEN, Viet Paul; BERKOVIC, Patrick; NOEL, Michaël; GOURMET, Noël; COUCKE, Philippe

doi:10.1016/j.canrad.2016.05.014

Article (Scientific journals)

Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Lakosi, Ferenc; GULYBAN, Akos; BEN MUSTAPHA, Selma et al.

2016 • In Cancer Radiotherapie, 3429

Peer Reviewed verified by ORBi

Permalink
https://hdl.handle.net/2268/206123

DOI
10.1016/j.canrad.2016.05.014

PubMed
27396903

Files (1)Send to Details Statistics Bibliography Similar publications

Files

Full Text

Feasability evaluation of prone breast irradiation with the Sagittilt system including residual-intrafractional error assesment.pdf

Publisher postprint (1.1 MB)

Download

All documents in ORBi are protected by a user license.

Send to

RIS BibTex APA Chicago Permalink X Linkedin

Details

Keywords :

Breast cancer; Cone-beam computed tomography; Set-up precision; Prone breast radiotherapy; Cancer du sein; Tomographie conique; Précision du placement; Radiothérapie en décubitus ventral

Abstract :

[en] Purpose:Feasibility evaluation of the Sagittilt© prone breast board system (Orfit Industries, Wijnegem, Belgium) for radiotherapy focusing on patient and staff satisfaction, treatment time, treatment reproducibility with the assessment of residual-intrafractional errors. Material and methods: Thirty-six patients underwent whole-breast irradiation in prone position. Seventeen received a sequential boost (breast: 42.56 Gy in 16 fractions, boost: 10 Gy in five fractions), while 19 patients received a concomitant boost protocol (breast/boost: 45.57/55.86 Gy in 21 fractions). Treatment verification included a daily online cone-beam CT (CBCT). In order to assess the residual and residual-intrafractional errors post-treatment CBCTs were performed systematically at the first five treatment sessions. Treatment time, patient comfort, staff satisfaction were also evaluated. Results: The pretreatment CBCT resulted in a population systematic error of 4.5/3.9/3.3 mm in lateral/longitudinal/vertical directions, while the random error was 5.4/3.8/2.8 mm. Without correction these would correspond to a clinical to planning target volume margin of 15.0/12.3/10.3 mm. The population systematic and random residual-intrafractional errors were 1.5/0.9/1.7 mm and 1.7/1.9/1.6 mm. Patient and staffs’ satisfaction were considered good and average. The mean treatment session time was 21 minutes (range: 13–40 min). Conclusion: The Sagittilt© system seems to be feasible for breast irradiation and well-tolerated by patients, acceptable to radiographers and reasonable in terms of treatment times. Set-up accuracy was comparable with other prone systems; residual errors need further investigations.
[fr] Objectif de l’étude: Évaluation de la faisabilité de l’irradiation du sein en décubitus ventral avec le système Sagittilt© (Orfit Industries, Wijnegem, Belgique) en étudiant la satisfaction du patient et du personnel soignant, le temps de traitement et la reproductibilité du traitement avec une évaluation de l’erreur résiduelle pendant les fractions. Méthodes: Trente-six patientes ont bénéficié d’une irradiation de la totalité du sein en décubitus ventral, 17 ont reçu un boost séquentiel (sein : 42,56 Gy en 16 fractions ; boost : 10 Gy en cinq fractions) et 19 patientes un boost concomitant (sein/boost : 45,57/55,86 Gy en 21 fractions). La vérification quotidienne du placement a été faite par une tomographie conique (CBCT). Pour évaluer l’erreur résiduelle pendant les fractions, une tomographie conique a été effectuée systématiquement après les cinq premières fractions. Le temps de traitement, le confort du patient ainsi que du personnel soignant ont également été évalués. Résultats: La tomographie conique avant le traitement a mis en évidence une erreur systématique de 4,5/3,9/3,3 mm dans les directions latérale/longitudinale/verticale, l’erreur aléatoire était de 5,4/3,8/2,8 mm. Sans correction, cela correspond à une marge du volume cible anatomoclinique (CTV) au volume cible prévisionnel (PTV) de 15,0/12,3/10,3 mm. L’erreur systématique et aléatoire pendant les fractions étaient respectivement de 1,5/0,9/1,7 mm et de 1,7/1,9/1,6 mm. La satisfaction du patient était considérée comme bonne et celle du personnel comme moyenne. Le temps moyen de traitement était de 21 minutes (13–40 min). Conclusion: Le système Sagittilt© est utilisable en routine et bien toléré par le patient, il est acceptable pour le personnel soignant avec des temps de traitement raisonnables. La précision de la mise en place est comparable avec d’autres systèmes de traitement en décubitus ventral. De plus amples investigations sont nécessaires afin d’évaluer les erreurs résiduelles.

Disciplines :

Oncology

Author, co-author :

Lakosi, Ferenc; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie

GULYBAN, Akos ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

BEN MUSTAPHA, Selma ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

NGUYEN, Viet Paul ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

BERKOVIC, Patrick ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

NOEL, Michaël ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

GOURMET, Noël ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

COUCKE, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

Language :

English

Title :

Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Alternative titles :

[en] Évaluation de la faisabilité de l’irradiation du sein en décubitus ventral avec le système Sagittilt© et de l’erreur résiduelle pendant les fractions

Publication date :

15 May 2016

Journal title :

Cancer Radiotherapie

ISSN :

1278-3218

eISSN :

1769-6658

Publisher :

Elsevier, Paris, France

Volume :

3429

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 26 January 2017

Statistics

Number of views

112 (6 by ULiège)

Number of downloads

431 (3 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

[1] Darby, S., McGale, P., Correa, C., Taylor, C., Arriagada, R., Clarke, M., et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378 (2011), 1707–1716, 10.1016/S0140-6736(11)61629-2.
[2] Darby, S.C., Ewertz, M., McGale, P., Bennet, A.M., Blom-Goldman, U., Brønnum, D., et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 368 (2013), 987–998, 10.1056/NEJMoa1209825.
[3] Grantzau, T., Thomsen, M.S., Væth, M., Overgaard, J., Risk of second primary lung cancer in women after radiotherapy for breast cancer. Radiother Oncol 111 (2014), 366–373, 10.1016/j.radonc.2014.05.004.
[4] Blom Goldman, U., Svane, G., Anderson, M., Wennberg, B., Lind, P., Long-term functional and radiological pulmonary changes after radiation therapy for breast cancer. Acta Oncol 53 (2014), 1373–1379, 10.3109/0284186X.2014.934967.
[5] Mulliez, T., Veldeman, L., van Greveling, A., Speleers, B., Sadeghi, S., Berwouts, D., et al. Hypofractionated whole-breast irradiation for patients with large breasts: a randomized trial comparing prone and supine positions. Radiother Oncol 108 (2013), 203–208, 10.1016/j.radonc.2013.08.040.
[6] De Langhe, S., Mulliez, T., Veldeman, L., Remouchamps, V., van Greveling, A., Gilsoul, M., et al. Factors modifying the risk for developing acute skin toxicity after whole-breast intensity modulated radiotherapy. BMC Cancer, 14, 2014, 711, 10.1186/1471-2407-14-711.
[7] Mukesh, M., Harris, E., Jena, R., Evans, P., Coles, C., Relationship between irradiated breast volume and late normal tissue complications: a systematic review. Radiother Oncol 104 (2012), 1–10, 10.1016/j.radonc.2012.04.025.
[8] Mast, M., Reynders, T., Heijenbrok, M., van Kempen-Harteveld, L., Van Parijs, H., Rozema, H., et al. Tangential IMRT versus TomoTherapy with and without breath-hold in left-sided whole-breast irradiation. Acta Oncol 55 (2016), 240–243, 10.3109/0284186X.2015.999.1046.
[9] Mulliez, T., Speleers, B., Madani, I., De Gersem, W., Veldeman, L., De Neve, W., Whole-breast radiotherapy in prone and supine position: is there a place for multibeam IMRT?. Radiat Oncol, 8, 2013, 151, 10.1186/1748-717X-8-151.
[10] Gulybán, A., Kovács, P., Sebestyén, Z., Farkas, R., Csere, T., Karácsonyi, G., et al. Multisegmented tangential breast fields: a rational way to treat breast cancer. Strahlenther Onkol 184 (2008), 262–269, 10.1007/s00066-008-1770-1.
[11] Kirova, Y.M., Hijal, T., Campana, F., Fournier-Bidoz, N., Stilhart, A., Dendale, R., et al. Whole-breast radiotherapy in the lateral decubitus position: a dosimetric and clinical solution to decrease the doses to the organs at risk (OAR). Radiother Oncol 110 (2014), 477–481, 10.1016/j.radonc.2013.10.038.
[12] Mulliez, T., Veldeman, L., Speleers, B., Mahjoubi, K., Remouchamps, V., Van Greveling, A., et al. Heart dose reduction by prone deep inspiration breath-hold in left-sided breast irradiation. Radiother Oncol 114 (2015), 79–84, 10.1016/j.radonc.2014.11.038.
[13] Bartlett, F.R., Colgan, R.M., Donovan, E.M., McNair, A.H., Carr, K., Evans, P.M., et al. The UK HeartSpare Study (Stage IB): randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast-conserving surgery. Radiother Oncol 114 (2015), 66–72, 10.1016/j.radonc.2014.11.018.
[14] Kirby, A.M.M., Evans, P.M.M., Helyer, S.J.J., Donovan, E.M.M., Convery, H.M.M., Yarnold, J.R.R., A randomised trial of supine versus prone breast radiotherapy (SuPr study): comparing set-up errors and respiratory motion. Radiother Oncol 100 (2011), 221–226, 10.1016/j.radonc.2010.11.005.
[15] Lakosi, F., Gulyban, A., Janvary, L., Simoni, S.B.-M., Jansen, N., Seidel, L., et al. Respiratory motion, anterior heart displacement and heart dosimetry: comparison between prone (pr) and supine (su) whole-breast irradiation. Pathol Oncol Res 21 (2015), 1051–1058, 10.1007/s12253-015-9932-9.
[16] Veldeman, L., De Gersem, W., Speleers, B., Truyens, B., Van Greveling, A., Van den Broecke, R., et al. Alternated prone and supine whole-breast irradiation using IMRT: set-up precision, respiratory movement and treatment time. Int J Radiat Oncol Biol Phys 82 (2012), 2055–2064, 10.1016/j.ijrobp.2010.10.070.
[17] Lakosi, F., Gulyban, A., Janvary, L., Simoni, S.B.-M., Sophie, N., Seidel, L., et al. The influence of treatment position (prone vs. supine) on clip displacement, seroma, tumor bed and partial breast target volumes: comparative study. Pathol Oncol Res 22 (2016), 493–500, 10.1007/s12253-015-0028-3.
[18] Lymberis, S.C.C., DeWyngaert, J.K.K., Parhar, P., Chhabra, A.M.M., Fenton-Kerimian, M., Chang, J., et al. Prospective assessment of optimal individual position (prone versus supine) for breast radiotherapy: volumetric and dosimetric correlations in 100 patients. Int J Radiat Oncol Biol Phys 84 (2012), 902–909, 10.1016/j.ijrobp.2012.01.040.
[19] Kirby, A.M.M., Evans, P.M.M., Donovan, E.M.M., Convery, H.M.M., Haviland, J.S.S., Yarnold, J.R.R., Prone versus supine positioning for whole and partial-breast radiotherapy: a comparison of non-target tissue dosimetry. Radiother Oncol 96 (2010), 178–184, 10.1016/j.radonc.2010.05.014.
[20] Mulliez, T., Speleers, B., Mahjoubi, K., Remouchamps, V., Gilsoul, M., Veldeman, L., et al. Prone left-sided whole-breast irradiation: significant heart dose reduction using end-inspiratory versus end-expiratory gating. Cancer Radiother 18 (2014), 672–677, 10.1016/j.canrad.2014.04.004.
[21] Ahunbay, E.E., Robbins, J., Christian, R., Godley, A., White, J., Li, X.A., Interfractional target variations for partial-breast irradiation. Int J Radiat Oncol Biol Phys 82 (2012), 1594–1604, 10.1016/j.ijrobp.2011.01.041.
[22] Jozsef, G., DeWyngaert, J.K., Becker, S.J., Lymberis, S., Formenti, S.C., Prospective study of cone-beam computed tomography image-guided radiotherapy for prone accelerated partial-breast irradiation. Int J Radiat Oncol Biol Phys 81 (2011), 568–574, 10.1016/j.ijrobp.2010.11.029.
[23] Veldeman, L., Speleers, B., Bakker, M., Jacobs, F., Coghe, M., De Gersem, W., et al. Preliminary results on set-up precision of prone-lateral patient positioning for whole-breast irradiation. Int J Radiat Oncol Biol Phys 78 (2010), 111–118, 10.1016/j.ijrobp.2009.07.1749.
[24] Mulliez, T., Gulyban, A., Vercauteren, T., van Greveling, A., Speleers, B., De Neve, W., et al. Set-up accuracy for prone and supine whole-breast irradiation. Strahlenther Onkol 192 (2016), 254–259, 10.1007/s00066-016-0943-6.
[25] Huppert, N., Jozsef, G., Dewyngaert, K., Formenti, S.C., The role of a prone set-up in breast radiation therapy. Front Oncol, 1, 2011, 31, 10.3389/fonc.2011.1.0003.
[26] Lansu, J.T.P., Essers, M., Voogd, A.C., Luiten, E.J.T., Buijs, C., Groenendaal, N., et al. The influence of simultaneous integrated boost, hypofractionation and oncoplastic surgery on cosmetic outcome and PROMs after breast-conserving therapy. Eur J Surg Oncol 41 (2015), 1411–1416, 10.1016/j.ejso.2015.07.011.
[27] De Puysseleyr, A., Mulliez, T., a Gulyban, E., Bogaert, T., Vercauteren, T., Van Hoof, et al. Improved cone-beam computed tomography in supine and prone breast radiotherapy. Surface reconstruction, radiation exposure, and clinical workflow. Strahlenther Onkol 189 (2013), 945–950, 10.1007/s00066-013-0435-x.
[28] van Herk, M., Remeijer, P., Rasch, C.J., Lebesque, V., The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. Int J Radiat Oncol Biol Phys 47 (2000), 1121–1135.
[29] Cai, G., Hu, W.-G., Chen, J.-Y., Yu, X.-L., Pan, Z.-Q., Yang, Z.-Z., et al. Impact of residual and intrafractional errors on strategy of correction for image-guided accelerated partial-breast irradiation. Radiat Oncol, 5, 2010, 96, 10.1186/1748-717X-5-96.
[30] Verhoeven, K., Sweldens, C., Petillion, S., Laenen, A., Peeters, S., Janssen, H., et al. Breathing adapted radiation therapy in comparison with prone position to reduce the doses to the heart, left anterior descending coronary artery, and contralateral breast in whole-breast radiation therapy. Pract Radiat Oncol 4 (2014), 123–129, 10.1016/j.prro.2013.07.005.
[31] Würschmidt, F., Stoltenberg, S., Kretschmer, M., Petersen, C., Incidental dose to coronary arteries is higher in prone than in supine whole-breast irradiation. A dosimetric comparison in adjuvant radiotherapy of early stage breast cancer. Strahlenther Onkol 190 (2014), 563–568, 10.1007/s00066-014-0606-4.
[32] Sung, K., Lee, K.C., Lee, S.H., Ahn, S.H., Lee, S.H., Choi, J., Cardiac dose reduction with breathing adapted radiotherapy using self-respiration monitoring system for left-sided breast cancer. Radiat Oncol J 32 (2014), 84–94, 10.3857/roj.2014.32.2.84.
[33] Cucchiaro, S., Dechambre, D., Ernst, C., Martin, N., Sequenzia, F., Ben Mustapha, S., et al. Clinical introduction of an all-in class solution for prone breast hypofractionated SIB with multibeam IMRT. Radiother Oncol, 111, 2014, 48.
[34] Hardee, M.E., Raza, S., Becker, S.J., Jozsef, G., Lymberis, S.C., Hochman, T., et al. Prone hypofractionated whole-breast radiotherapy without a boost to the tumor bed: comparable toxicity of IMRT versus a 3D conformal technique. Int J Radiat Oncol Biol Phys 82 (2012), e415–e423, 10.1016/j.ijrobp.2011.06.1950.