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000278339 1001_ $$00000-0002-7547-1304$$aVakaet, Vincent$$b0
000278339 245__ $$aComparison of prone and supine positioning for breast cancer radiotherapy using REQUITE data: dosimetry, acute and two years physician and patient-reported outcomes.
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000278339 500__ $$a2023 Sep;62(9):1036-1044
000278339 520__ $$aMost patients receive whole breast radiotherapy in a supine position. However, two randomised trials showed lower acute toxicity in prone position. Furthermore, in most patients, prone positioning reduced doses to the organs at risk. To confirm these findings, we compared toxicity outcomes, photographic assessment, and dosimetry between both positions using REQUITE data.REQUITE is an international multi-centre prospective observational study that recruited 2069 breast cancer patients receiving radiotherapy. Data on toxicity, health-related quality of life (HRQoL), and dosimetry were collected, as well as a photographic assessment. A matched case control analysis compared patients treated prone (n = 268) versus supine (n = 493). Exact matching was performed for the use of intensity-modulated radiotherapy, boost, lymph node irradiation, chemotherapy and fractionation, and the nearest neighbour for breast volume. Primary endpoints were dermatitis at the end of radiotherapy, and atrophy and cosmetic outcome by photographic assessment at two years.At the last treatment fraction, there was no significant difference in dermatitis (p = .28) or any HRQoL domain, but prone positioning increased the risk of breast oedema (p < .001). At 2 years, patients treated in prone position had less atrophy (p = .01), and higher body image (p < .001), and social functioning (p < .001) scores. The photographic assessment showed no difference in cosmesis at 2 years (p = .22). In prone position, mean heart dose (MHD) was significantly lower for left-sided patients (1.29 Gy vs 2.10 Gy, p < .001) and ipsilateral mean lung dose (MLD) was significantly lower for all patients (2.77 Gy vs 5.89 Gy, p < .001).Prone radiotherapy showed lower MLD and MHD compared to supine position, although the risk of developing breast oedema during radiotherapy was higher. At 2 years the photographic assessment showed no difference in the cosmetic outcome, but less atrophy was seen in prone-treated patients and this seems to have a positive influence on the HRQoL domain of body image.
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000278339 650_7 $$2Other$$aBreast cancer
000278339 650_7 $$2Other$$adosimetry
000278339 650_7 $$2Other$$ahealth-related quality of life
000278339 650_7 $$2Other$$aprone position
000278339 650_7 $$2Other$$aradiotherapy toxicity
000278339 7001_ $$00000-0002-4867-9847$$aDeseyne, Pieter$$b1
000278339 7001_ $$aBultijnck, Renée$$b2
000278339 7001_ $$aPost, Giselle$$b3
000278339 7001_ $$aWest, Catharine$$b4
000278339 7001_ $$aAzria, David$$b5
000278339 7001_ $$aBourgier, Celine$$b6
000278339 7001_ $$aFarcy-Jacquet, Marie-Pierre$$b7
000278339 7001_ $$aRosenstein, Barry$$b8
000278339 7001_ $$aGreen, Sheryl$$b9
000278339 7001_ $$ade Ruysscher, Dirk$$b10
000278339 7001_ $$aSperk, Elena$$b11
000278339 7001_ $$aVeldwijk, Marlon$$b12
000278339 7001_ $$aHerskind, Carsten$$b13
000278339 7001_ $$aDe Santis, Maria Carmen$$b14
000278339 7001_ $$aRancati, Tiziana$$b15
000278339 7001_ $$aGiandini, Tommaso$$b16
000278339 7001_ $$0P:(DE-He78)c259d6cc99edf5c7bc7ce22c7f87c253$$aChang-Claude, Jenny$$b17$$udkfz
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000278339 7001_ $$aLambrecht, Maarten$$b19
000278339 7001_ $$aWeltens, Caroline$$b20
000278339 7001_ $$aJanssens, Hilde$$b21
000278339 7001_ $$aVega, Ana$$b22
000278339 7001_ $$aTaboada-Valladares, Maria Begoña$$b23
000278339 7001_ $$00000-0002-7822-6726$$aAguado-Barrera, Miguel Elías$$b24
000278339 7001_ $$aReyes, Victoria$$b25
000278339 7001_ $$aAltabas, Manuel$$b26
000278339 7001_ $$aGutiérrez-Enríquez, Sara$$b27
000278339 7001_ $$aMonten, Christel$$b28
000278339 7001_ $$aVan Hulle, Hans$$b29
000278339 7001_ $$aVeldeman, Liv$$b30
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