title: Feasibility evaluation of prone breast irradiation with the Sagittilt©system including residual-intrafractional error assessment.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Thirty-six patients underwent whole-breast irradiation in prone position. Seventeen received a sequential boost (breast: 42.56Gy in 16 fractions, boost: 10Gy in five fractions), while 19 patients received a concomitant boost protocol (breast/boost: 45.57/55.86Gy 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 4.5/3.9/3.3mm in lateral/longitudinal/vertical directions, while the random error was 5.4/3.8/2.8mm. Without correction these would correspond to a clinical to planning target volume margin of 15.0/12.3/10.3mm. The population systematic and random residual-intrafractional errors were 1.5/0.9/1.7mm and 1.7/1.9/1.6mm. Patient and staffs' satisfaction were considered good and average. The mean treatment session time was 21minutes (range: 13-40min).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium. Electronic address: lakosiferenc@yahoo.com.
authors.forename: F
authors.initials: F
authors.lastname: Lakosi
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Gulyban
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Ben-Mustapha Simoni
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Viet Nguyen
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Berkovic
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Noël
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Gourmet
authors.affiliation: Department of Radiation Oncology, University Hospital of Liège, avenue de l'Hôpital, B.35, 4000 Liège, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Coucke
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D054893:Cone-Beam Computed Tomography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D059351:Organ Sparing Treatments; D058958:Organs at Risk; D056888:Patient Positioning / Q000295:instrumentation*; D017060:Patient Satisfaction; D016684:Prone Position; D011880:Radiotherapy Planning, Computer-Assisted; D061089:Radiotherapy, Image-Guided / Q000379:methods
keywords: Breast cancer; Cancer du sein; Cone-beam computed tomography; Prone breast radiotherapy; Précision du placement; Radiothérapie en décubitus ventral; Set-up precision; Tomographie conique