The UK HeartSpare Study (Stage IB): randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Frederick R BartlettAnna M Kirby

Abstract

To compare mean heart and left anterior descending coronary artery (LAD) doses (NTDmean) and positional reproducibility in larger-breasted women receiving left breast radiotherapy using supine voluntary deep-inspiratory breath-hold (VBH) and free-breathing prone techniques. Following surgery for early breast cancer, patients with estimated breast volumes >750 cm(3) underwent planning-CT scans in supine VBH and free-breathing prone positions. Radiotherapy treatment plans were prepared, and mean heart and LAD doses were calculated. Patients were randomised to receive one technique for fractions 1-7, before switching techniques for fractions 8-15 (40 Gy/15 fractions total). Daily electronic portal imaging and alternate-day cone-beam CT (CBCT) imaging were performed. The primary endpoint was the difference in mean LAD NTDmean between techniques. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. 34 patients were recruited, with complete dosimetric data available for 28. Mean heart and LAD NTDmean doses for VBH and prone treatments respectively were 0.4 and 0.7 (p<0.001) and 2.9 and 7.8 (p<0.001). Clip-based CBCT errors for VBH and prone resp...Continue Reading

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Citations

Aug 14, 2015·The British Journal of Radiology·Ruth ColganEllen M Donovan
Sep 20, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Stefanie CorradiniJutta Engel
Nov 29, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Harry Bartelink
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Dec 22, 2021·The British Journal of Radiology·Michael John ParkesThomas Clutton-Brock

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