Effect of Change in the Neck Position on Dosimetric Parameters of the Oesophagus in Breast Cancer Patients Undergoing Supraclavicular Irradiation

Abstract

BackgroundA limited number of publications examine approaches to decreasing esophageal dose and acute esophagitis during breast cancer radiotherapy (RT).
 ObjectivesThis study aimed to analyze the effect of the two different neck positions when the neck turned to the contralateral side or straight on dosimetric parameters such as mean dose (Dmean) maximum dose (Dmax), and volume of esophagus receiving doses (Vx), in breast patients (BC) who require supraclavicular irradiation.
 Materials and MethodsOf all patients undergoing chest wall and supraclavicular regional node irradiation with a dose of 40Gy in 15 fractions, 25 patients were simulated with their necks straight (NS) group, whereas 25 patients with tilted neck position (NT) group. Dmean, Dmax, V5, V10, V15, and V20 were calculated and converted to EQD2 (Equivalent dose in 2 Gy fractions).
 ResultsDmean, V5, V10, V15, and V20 were significantly lower in (straight neck position) SN group patients when compared to the (tilted neck position) TN group (P values <0.05). Dmax was slightly higher in the SN group than the NT group (p= 0.083). When the laterality of breast cancer was evaluated in the two groups, all dosimetric parameters (Dmax, Dmean, V5, V10, V15, and V20 ) were higher in left-sided breast cancer as compared in right-sided breast cancer for SN and NT groups (P values <0.05).
 ConclusionWe found that the positioning of a straight neck resulted in considerable oesophagal sparing. Therefore, esophagitis may be reduced, which substantially impacts the quality of life of BC survivors.