Abstract
Our recently developed prone crawl position (PCP) for radiotherapy of breast cancer patients with lymphatic involvement showed promising preliminary data and it is being optimized for clinical use. An important aspect in this process is making new, position specific delineation guidelines to ensure delineation (for treatment planning) is uniform across different centers. The existing ESTRO and PROCAB guidelines for supine position (SP) were adapted for PCP. Nine volunteers were MRI scanned in both SP and PCP. Lymph node regions were delineated in SP using the existing ESTRO and PROCAB guidelines and were then translated to PCP, based on the observed changes in reference structure position. Nine PCP patient CT scans were used to verify if the new reference structures were consistently identified and easily applicable on different patient CT scans. Based on these data, a team of specialists in anatomy, CT- and MRI radiology and radiation oncology postulated the final guidelines. By taking the ESTRO and PROCAB guidelines for SP into account and by using a relatively big number of datasets, these new PCP specific guidelines incorporate anatomical variability between patients. The guidelines are easily and consistently applicable, even for people with limited previous experience with delineations in PCP.
Highlights
Our recently developed prone crawl position (PCP) for radiotherapy of breast cancer patients with lymphatic involvement showed promising preliminary data and it is being optimized for clinical use
We recently introduced a new patient position with complementary positioning device to allow nodal radiotherapy in prone p osition[10]
To confirm that new MRI based reference structures were applicable in a clinical setting, they were subsequently applied on 9 patient CT scans (PCP patient CT) with lower contrast detail
Summary
Our recently developed prone crawl position (PCP) for radiotherapy of breast cancer patients with lymphatic involvement showed promising preliminary data and it is being optimized for clinical use. Nine PCP patient CT scans were used to verify if the new reference structures were consistently identified and applicable on different patient CT scans Based on these data, a team of specialists in anatomy, CT- and MRI radiology and radiation oncology postulated the final guidelines. The European ESTRO14 and PROCAB (project on cancer of the breast)[13] guidelines differ only slightly from one another and have been shown to provide better nodal coverage and include less healthy tissue than the RTOG guidelines[19,20]. These guidelines were chosen as a starting point for PCP guideline development. The aim of this study was to create new PCP specific delineation guidelines, to provide a uniform standard for centers that wish to implement the technique in the future
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
