Breast radiotherapy in the lateral decubitus position: A technique to prevent lung and heart irradiation.
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.
Campana
François
F
Department of Radiation Oncology, Institute Curie, Paris, France. francois.campana@curie.net
Kirova
Youlia M
YM
Rosenwald
Jean-Claude
JC
Dendale
Remi
R
Vilcoq
Jacques R
JR
Dreyfus
Hélène
H
Fourquet
Alain
A
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