Institut Curie guidelines on breast target volume delineation for patients treated in lateral position |
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| Institution: | 1. Department of radiation oncology, Institut Curie, 26, rue d’Ulm, 75005 Paris, France;2. Department of surgical oncology, Institut Curie, 26, rue d’Ulm, 75005 Paris, France;3. Department of radiology, Institut Curie, 26, rue d’Ulm, 75005 Paris, France;1. Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California;2. Brown University, Providence, Rhode Island;3. University of Southern California, Los Angeles, California;1. Department of Radiotherapy, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200–319 Porto, Portugal;2. Departamento de Estudo de Populações, Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Rua de Jorge Viterbo Ferreira, No. 228, 4050-313 Porto, Portugal;3. CINTESIS, Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Rua de Jorge Viterbo Ferreira, No. 228, 4050-313 Porto, Portugal;4. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, No. 135, 4050-600 Porto, Portugal;1. Centre François Baclesse, 3, avenue General Harris, 14076 Caen, France;2. Centre Antoine Lacassagne, Nice, France;3. Centre Marie Curie, Valence, France;4. Centre Jean Bernard, Mans–Tours, France;5. Center Léon Bérard, Lyon, France;6. Center Eugene Marquis, Rennes, France;7. Centre hospitalier et universitaire Tenon, Paris, France;8. Institut de Cancérologie de Lorraine, Nancy, France;9. Institut de Cancérologie Strasbourg Europe, Strasbourg, France;10. Institut Gustave Roussy, Villejuif, France;11. Centre hospitalier régional et universitaire, Besançon-Montbéliard, France;12. Centre hospitalier universitaire vaudois, Lausanne, Switzerland;13. Corpuscular Physics Laboratory–Normandy University, Caen, France |
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| Abstract: | PurposeTo develop guidelines for and describe the delineation of breast for patients treated in lateral position and to transform this three-dimensional technique based on the virtual simulation to volume-based modern intensity-modulated irradiation technique.Material and methodsIn our department, during the daily delineation, radiation oncologists specialized in breast cancer treatment sought consensus on the delineation of clinical treatment volume of the breast through dialogue based on cases. A radiation oncologist delineated clinical treatment volumes on CT scans of five to 20 patients, followed by a discussion and adaptation of the delineation between all radiation oncologists of the team. The consensus established between clinicians was discussed, corrected and improved. All patients were delineated in treatment position; skin markers were used to visualize the breast tissue after careful palpation.ResultsBreast clinical treatment volume was situated and delineated between pectoral muscle and 5 mm below the skin (dosimetric considerations), within the space outlined by skin markers, that showed the limits of the palpable breast tissue. In lateral position some vessels were very useful to define the limits as rami mammarii (from thoracica interna) for the internal one and thoracica lateralis for the external. This is the first atlas proposed for the delineation of the breast clinical treatment volumes for breast cancer using alternative technique of breast irradiation (lateral).ConclusionThis atlas will be helpful for the volume definition in our daily practice of breast irradiation in lateral position and can open perspectives to develop also atlases for other alternative techniques as treatment in prone position. |
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| Keywords: | Early-stage breast cancer Radiotherapy Volume delineation Lateral position Breast-conserving surgery Cancer du sein Stade précoce Radiothérapie Délinéation Volume Sein Décubitus latéral isocentrique Chirurgie conservatrice |
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