Leo cancer care exhibiting at ASRT 2026

Increased lung volumes upright suggest that improved cardiac and lung sparing could be achievable for breast radiotherapy. A recent study concluded that, upright body positioning for breast radiotherapy appears to be comfortable and feasible [1].

A study by Alghadir et al found that difficulty swallowing was 6 times greater when a patient is lying down with their neck extended compared to upright [3]. Suggesting that being treated in an upright position will help patients better manage thick oral secretions and reduce the risk of aspiration and patient anxiety.

A research paper by the Paul Scherrer Institute identified that when a patient lies down the liver can drift and deform in position up to 20mm over 35 minutes [2] . This could affect tumour location and accuracy during treatment when patients are in the supine position.

A study by a team at MD Anderson suggested that in the upright orientation, lung volume was on average 25% larger but in some cases up to 50% larger [5]. This increased lung volume suggested a reduction in breathing motion, allowing clinicians to challenge current treatment margins for thoracic tumours.

Recent data indicated that when upright, the prostate has been shown to move less. Its position is unaffected by changes in bladder fill, the seminal vesicles are pushed down by the bladder allowing them to be included in treatment volumes without compromising on healthy tissue, the space between sacrum and anterior bladder wall is also significantly smaller [4].

1. Boisbouvier, S., et al (2023). Upright patient positioning for gantry-free breast radiotherapy: feasibility tests using a robotic chair and specialised bras.
2. Siebenthal, M., et al. (2007) Systematic errors in respiratory gating due to intrafraction deformations of the liver
3. Alghadir, A., Zafar, H., Al-Eisa, E., Iqbal, Z. (2017) Effects of posture on swallowing.
4. Schreuder, N., et al (2023) Anatomical changes in the male pelvis between the supine and upright position
5. Yang J, Chu D, Dong L, Court LE. (2023) Advantages of simulating thoracic cancer patients in an upright position.
6. Boisbouvier S, Boucaud A, Tanguy R, Grégoire V. (2022) Upright patient positioning for pelvic radiotherapy treatments.