Research Papers:

Evaluation of the anatomical parameters for normal tissue sparing in the prone position radiotherapy with small sized left breasts

Hyunjung Kim and Jinyoung Kim _

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Oncotarget. 2016; 7:72211-72218. https://doi.org/10.18632/oncotarget.12662

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Hyunjung Kim1,2, Jinyoung Kim1

1Department of Radiation Oncology, Inje University Haeundae Paik Hospital, Busan, Korea

2Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea

Correspondence to:

Jinyoung Kim, email: [email protected]

Keywords: breast cancer, prone position, small breast, radiotherapy, heart saving

Received: August 24, 2016     Accepted: October 07, 2016     Published: October 14, 2016


Prone position radiotherapy for a small (< 750 cm3) breast is controversial because of the variable benefits for the irradiated heart volume. The objective anatomical parameters related with chest wall shape that can determine the heart dose sparing patients in the prone position.

Twenty-one patients underwent CT-simulation in supine and prone position. Dose volume parameters were compared and the objective indexes such as the Haller index, anthropometric index, mid-sternum thickness, and central lung distance (CLD) were evaluated the relationship between the shape of the chest wall and irradiated normal tissue volume in prone position.

The median breast volume was 440.10 cm3 (range, 151.5–727.41 cm3). There was no difference of breast target volume between supine and prone position (p = 0.178). The Haller index under 2.5 (p = 0.046), an anthropometric index over 0.05 (p = 0.007), and the CLD over 2 (p = 0.023) conferred a greater heart sparing effect in the prone position.

In conclusions, the objective anatomical parameters related chest wall shape predict the decrease in irradiated heart volume in the prone position. Therefore, it is possible to screen for patients with a reduced heart volume irradiation among those with small breasts before applying prone position radiotherapy.

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