title: Breast radiotherapy in the lateral decubitus position: A technique to prevent lung and heart irradiation.
abstract: OBJECTIVE
  To present an original technique for breast radiotherapy, with the aim of limiting lung and heart irradiation, satisfying quality assurance criteria.
  
  
  METHODS
  An original radiotherapy technique for breast irradiation has been developed at the Institute Curie in January 1996. It consists of isocentric breast irradiation in the lateral decubitus position (isocentric lateral decubitus [ILD]). This technique is indicated for voluminous or pendulous breasts needing breast irradiation only. Thin carbon fiber supports and special patient positioning devices have been developed especially for this technique. In vivo measurements were performed to check the dose distribution before the routine use of the technique.
  
  
  RESULTS
  ILD has been successfully implemented in routine practice, and 500 patients have been already treated. Breast radiotherapy is performed using a dose of 50 Gy at ICRU point in 25 fractions. ILD shows good homogeneity of the dose in breast treatment volume, treatment fields are perpendicular to the skin ensuring its protection, and extremely low dose is delivered to the underlying lung and heart.
  
  
  CONCLUSIONS
  In cases of voluminous breasts or patients with a history of lung and heart disease, our technique provides several advantages over the conventional technique with opposing tangential fields. This technique improves the dose homogeneity according to the ICRU recommendations.
authors.affiliation: Department of Radiation Oncology, Institute Curie, Paris, France. francois.campana@curie.net
authors.forename: François
authors.initials: F
authors.lastname: Campana
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Rosenwald
authors.forename: Remi
authors.initials: R
authors.lastname: Dendale
authors.forename: Jacques R
authors.initials: JR
authors.lastname: Vilcoq
authors.forename: Hélène
authors.initials: H
authors.lastname: Dreyfus
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006321:Heart / Q000528:radiation effects*; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D015412:Mastectomy, Segmental; D011187:Posture; D011832:Radiation Injuries / Q000517:prevention & control*; D011859:Radiography; D018714:Radiotherapy, Adjuvant