Prone Crawl Breast Couch improves the treatment of breast cancer

Patient treated on a second generation Prone Crawl Breast Couch at UZ-Ghent. (large view)

Patient treated on a second generation Prone Crawl Breast Couch at UZ-Ghent.

(08-05-2020) The Prone Crawl Breast Couch addresses the disadvantages of current commercial prone positioning devices and improves the comfort of patients.

In Belgium, more than 10,000 patients per year are diagnosed with breast cancer, which is one of the highest incidences in Europe and still increasing. More than 70% of the patients receive radiotherapy as part of the modern multimodality therapeutic approach. Most patients are treated in supine position although it is proven that prone radiotherapy reduces acute toxicity and lowers the risk of radiation-induced lung cancer and cardiac damage. Current commercial devices for prone breast radiotherapy have several limitations: suboptimal design for breast+lymphnode irradiation, reduced positional stability, precision and comfort as compared to supine patient support devices.

 

The Prone Crawl Breast Couch, invented (2013) and developed by professor Wilfried De Neve and his team at Ghent University, addresses the disadvantages of current commercial prone positioning devices. Its distinguishing feature is support in prone crawl position (figure 1) instead of the position with both arms elevated on commercial devices. Five studies (4 published) reflect state-of-art regarding the Prone Crawl Breast Couch [1-4]. Ergonomic, biomechanical and in-silico studies showed improved patient comfort and stability and demonstrated feasibility of prone breast+lymphnode irradiation. The unpublished study shows that the Prone Crawl Breast Couch resulted in equal patient set-up precision to supine treatment. In-silico trials showed reduced lung, heart, thyroid, esophagus and contralateral breast doses for the Prone Crawl Breast Couch, halving radiation-related mortality risk, as compared to the best supine techniques.

 

The third device generation is currently being validated at UZ Ghent in a randomized clinical trial (NCT03280719) including 386 patients. To make the trial multicentric, 12 more devices have been manufactured (4 shipped to Bordet-ULB, 4 shipped to Namur-UCL and 4 kept at Ghent University as back-up devices for the 3 centers). The application for CE-certification as class-I medical device has been submitted to FAGG on February 13, 2020.

Favorable experience at UZ-Ghent and CHU-Namur-UCL with a 5-fraction dose-prescription, derived from the UK FAST trials triggered investigating pre-operative prone crawl radiotherapy with neo-adjuvant chemotherapy (NCT03783364). A further reduction of toxicity and gain of efficacy is expected from pre-operative implementation of the Prone Crawl Breast Couch.

 

Ghent University has patented the Prone Crawl Breast Couch and is currently preparing the spin-off of this technology. The spin-off strategy involves parallel developments. One route of development aims at marketing the fourth device generation through a spin-off company expected to be launched at the end of 2020. At Ghent University Campus Heymans and Campus Kortrijk, the parallel route of development aims at further enlarging the functionality of the Prone Crawl Breast Couch and its scope of clinical applications. MRI-compatible and fully x-ray translucent prototypes have already been manufactured. Current development and validation might lead to marketing in the near future.

 

Do you also have the ambition to start-up a spin-off based on your academic research? Learn more about the Ghent University Venture Track!

 

References

1.Boute,et.al.J.Appl.Clin.Med.Phys.2017;18(4):200-

2.Boute,et.al.Appl.Ergon.2018;72:48-

3.Deseyne,et.al.Radiat.Oncol.2017,12(1):89-

4.Speleers,et.al.Sci.Rep.2019,9(1):4755-

 

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