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العنوان
Prone versus Supine Positioning for Breast Cancer Radiotherapy in Patients with Pendulous Breast /
المؤلف
Amin, Eman Abdelnaby.
هيئة الاعداد
باحث / إيمان عبد النبي أمين
مشرف / سهير حلمي محمود
مشرف / أمين السيد احمد أمين
مشرف / أحمد عزت عيسى
الموضوع
Breast Cancer.
تاريخ النشر
2018.
عدد الصفحات
258 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
علم الأورام
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم علاج الاورام والطب النووي
الفهرس
Only 14 pages are availabe for public view

from 258

from 258

Abstract

Breast cancer is one of the most common cancers in women, surgical treatment for breast cancer had traditionally been radical mastectomy. Over the past decade, the decrease in death rates from breast cancer is largely attributed to the improvements in early detection and treatment. Women presented with early stage breast cancer have the option of electing breast-conserving surgery with adjuvant whole breast irradiation and has been shown in several large randomized controlled trials to yield local control and survival rates equivalent to those of mastectomy. Whole breast irradiation is typically delivered in the supine position, which is considered to deliver adequate results while also having a more reproducible set up. However, in the case of patients with pendulous breasts, potential clinical problems arise when trying to adequately treat the planned target volume, while sparing critical structures including lung and heart. Adverse events following irradiation of breast include pain, pigmentation and ulceration of the skin, soft tissue fibrosis, myocardial infarction, pericardial effusion, and asymptomatic or symptomatic lung damage had been reported. Several studies showed advantages of the prone position include a more homogenous dose distribution with a reduction in the size of the hot spots, resulting in decreased acute reactions, and irradiation of less normal tissue especially in patients with pendulous breast. Other studies showed that, the prone position was better than the supine position for sparing both lung and the heart in the majority of left breast cancer patients, especially in case of large breasts. from our prospective study, the delivery of whole breast radiotherapy using 3D-CRT in the prone position resulted in excellent reduction acute skin toxicity profiles and allowed a significant decrease of ipsilateral lung dose in right sided breast cancer patients and a favorable trend for heart dose in patients with left sided cancer. Overall, the prone position offered a favorable alternative for irradiation of pendulous breasts. In clinical practice, the choice of the treatment position should be based on an accurate analysis of each individual case.