Organ at risk sparing by non-coplanar prone breast radiotherapy on Halcyon/Ethos linacs utilizing breast couch slewing
Speleers, B.; Stouthandel, M.E.J.; Vakaet, V.; Paelinck, L.; Schoepen, M.; Van Greveling, A.; Van Esch, A.; Wéra, A.-C.; Remouchamps, V.; Van Hoof, T.; Veldeman, L.; De Gersem, W.; De Neve, W. (2026). Organ at risk sparing by non-coplanar prone breast radiotherapy on Halcyon/Ethos linacs utilizing breast couch slewing. NPG Scientific Reports article in press. https://dx.doi.org/10.1038/s41598-026-54571-4
In: Scientific Reports (Nature Publishing Group). Nature Publishing Group: London. ISSN 2045-2322; e-ISSN 2045-2322, more
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| Keywords |
Cancer
Diseases > Neoplasms > Breast cancer
Medical and health sciences > Basic sciences > Oncology
Medical research
Physics
Prone position
Radiotherapy
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| Author keywords |
Organ at risk sparing; Treatment planning; Deep inspiration breath hold |
| Authors | | Top |
- Speleers, B.
- Stouthandel, M.E.J.
- Vakaet, V.
- Paelinck, L.
- Schoepen, M., more
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- Van Greveling, A.
- Van Esch, A.
- Wéra, A.-C.
- Remouchamps, V.
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- Van Hoof, T.
- Veldeman, L.
- De Gersem, W.
- De Neve, W.
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| Abstract |
Organ at risk (OAR)-dose reductions are needed to minimize radiation toxicity in settings with high OAR-doses, like adjuvant breast and lymph node radiotherapy. Non-coplanar techniques, combined with prone positioning and deep inspiration breath hold (DIBH) techniques, could accomplish this. A planning study was performed in patients requiring left-side adjuvant breast and axillary/periclavicular lymph node irradiation (n = 8). Simulation was performed in prone crawl position using DIBH. Coplanar and non-coplanar short-arc VMAT plans were compared. Non-coplanar plans featured ≤ 20° angular separation between planes. Feasibility was tested using a CAD model, including a prone crawl breast couch positioned in an up to 20° angle (transverse plane) with the couchtop. Non-coplanar techniques can further reduce radiation exposure. Adding beams in planes with ± 15° to ± 20° angular separation with the transverse plane yielded > 20% mean-dose reductions simultaneously to heart, lungs and esophagus, compared to coplanar plans. Plans with ≤ ± 20° angular separation with the transverse plane proved feasible on linacs lacking couch isocenter rotations. Angular separation of ± 15° seems the best compromise between OAR-sparing and technical challenges. Non-coplanar radiotherapy options yielded superior OAR sparing compared to coplanar techniques in patients requiring adjuvant breast and lymph node irradiation and should be considered for improved radiation toxicity prevention. |
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