Background: This meta-analysis evaluates the difference of sparing organs at risk (OAR) in different position (Prone position and Supine position) with different breathing patterns (Free breathing, FB/Deep inspiration breath hold, DIBH) for breast cancer patients receiving postoperative radiotherapy and provides a useful reference for clinical practice.
Method: The relevant controlled trials of prone position versus supine position in postoperative radiotherapy for breast cancer were retrieved from the sources of PubMed, Cochrane Library, Embase, Web of Science and ClinicalTrails.gov. The principal outcome of interest was OAR doses (heart dose, left anterior descending coronary artery dose and ipsilateral lung dose) and target coverage. We mainly compared the effects of P-FB (Prone position FB) and S-FB (Supine position FB) and discussed the effects of DIBH combined with different positions on OAR dose in postoperative radiotherapy. We calculated summary standardized mean difference (SMD) and 95% confidence intervals (CI). The meta-analysis was performed using RevMan 5.4 software.
Results: The analysis included 751 patients from 19 observational studies. Compared with the S-FB, the P-FB can have lower heart dose, left anterior descending coronary artery (LADCA) dose, and ipsilateral lung dose (ILL) more effectively, and the difference was statistically significant (heart dose, SMD = - 0.51, 95% CI - 0.66 ∼ - 0.36, P < .00001. LADCA dose, SMD = - 0.58, 95% CI - 0.85 ∼ - 0.31, P < .0001. ILL dose, SMD = - 2.84, 95% CI - 3.2 ∼ - 2.48, P < .00001). And there was no significant difference in target coverage between the S-FB and P-FB groups (SMD = - 0.1, 95% CI - 0.57 ∼ 0.36, P = .66). Moreover, through descriptive analysis, we found that P-DIBH (Prone position DIBH) has better sparing OAR than P-FB and S-DIBH (Supine position DIBH).
Conclusion: By this meta-analysis, compared with the S-FB we found that implementation of P-FB in postoperative radiotherapy for breast cancer can reduce irradiation of heart dose, LADCA dose and ILL dose, without compromising mean dose of target coverage. Moreover, P-DIBH might become the most promising way for breast cancer patients to undergo radiotherapy.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136988 | PMC |
| http://dx.doi.org/10.1097/MD.0000000000026000 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Surgical correction of a chin-on-abdomen deformity due to ankylosing spinal deformity and obesity: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois.
Background: Kyphotic spinal deformity is a complication of ankylosing spondylitis (AS). In rare cases, particularly in obese patients, the deformity might extend to the cervicothoracic spine, resulting in a severe "chin-on-abdomen" deformity. This condition severely impairs quality of life by affecting gaze, swallowing, and causing chronic pain.
View Article and Find Full Text PDFTele-robot-assisted minimally invasive esophagectomy using a double-surgeon cockpit on a cadaver.
Surg Today
January 2025
Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.
We conducted this study to evaluate the efficacy of robot-assisted minimally invasive esophagectomy (RAMIE) on cadavers in the prone position, utilizing telesurgical support through the double-surgeon cockpit (double SC) of the novel Japanese-made surgical robot system, hinotori (Medicaroid, Kobe, Japan). The Cadaveric Anatomy and Surgical Training Laboratory (CAST Lab) at Hokkaido University and Kushiro City General Hospital (KCGH) are interconnected by a dedicated 1 Gbps internet line, spanning 300 km. An operation unit and double SC were installed at CAST Lab, whereas the double SC proctor was installed at KCGH.
View Article and Find Full Text PDFExtracorporeal membrane oxygenation for Chinese neonates with severe respiratory and cardiac failure.
J Cardiothorac Surg
January 2025
Department of PICU of Pediatric Medicine, Seventh Medical Center, PLA General Hospital, Beijing, 100000, China.
Objective: We aimed to outline the experience with extracorporeal membrane oxygenation (ECMO) for respiratory and cardiac failure in neonates in our institution and compare our results with those from other countries.
Method: The clinical data of 28 neonates who required ECMO assistance were studied retrospectively.
Results: A total of 28 neonates underwent support with veno-arterial ECMO, including 14 cardiac support and 14 respiratory support.
Optimizing Management of Acute Respiratory Distress Syndrome in Critically Ill Surgical Patients: A Systematic Review.
J Surg Res
January 2025
Division of Trauma and Surgical Critical Care, Department of Surgery, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida. Electronic address:
Introduction: This systematic review aims to evaluate the optimal management of acute respiratory distress syndrome (ARDS) in critically ill surgical patients, specifically focusing on positioning, extracorporeal membrane oxygenation (ECMO) use, ventilation, fluid resuscitation, and pharmacological treatments.
Methods: A systematic review was conducted utilizing four databases including PubMed, Google Scholar, EMBASE, and ProQuest. This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with The International Prospective Register of Systematic Reviews.
Invasive mechanical ventilation strategies, adjuvants treatments and adverse events among ICU patients with COVID-19 in Denmark.
Acta Anaesthesiol Scand
February 2025
Department of Anesthesiology and Intensive Care, Kolding Hospital, Denmark.
Aim: To describe the use of invasive mechanical ventilation core strategies, adjuvant treatments and the occurrence of barotrauma and prolonged ventilation in ICU patients with COVID-19 in Denmark, retrospectively.
Methods: All ICUs admitting COVID-19 patients in Denmark from 10 March 2020 to 2 April 2021 were invited to participate. All patients with COVID-19 who received invasive mechanical ventilation were included and data was retrospectively collected from electronic patient records.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!