What positions and immobilization strategies do you use to minimize breast and heart dose when treating axillary and mediastinal nodes in young women with large breasts who require consolidative radiation (ISRT) for Hodgkins lympoma?

Any experience treating patients prone with openings for both breasts, no minimize breast overlap with axilla and mediastinum?

Answer from: Radiation Oncologist at Community Practice

With photon based radiotherapy, I would use a 30 degree slant board if available, deep inspiration breath hold and partial arcs with avoidance parameters for the heart, lungs and breast. The other alternative here is protons.

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What positions and immobilization strategies do you use to minimize breast and heart dose when treating axillary and mediastinal nodes in young women with large breasts who require consolidative radiation (ISRT) for Hodgkins lympoma?

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