Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Department of Radiation Oncology, New York University School of Medicine, New York (firstname.lastname@example.org).
In Reply: We agree with Dr Sherr that the radiation dose to the left anterior descending (LAD) coronary artery may be relevant to the severity of late effects of heart irradiation in patients with breast cancer.1 Our prospective trial selected the treatment position based on the least volume of heart and lung included in the fields of breast irradiation when the patient was imaged in the supine vs prone positions. Dosimetric analysis in both positions was conducted for the first consecutive 100 patients, confirming that in-field volume is a reliable surrogate for dose.2
Formenti SC, DeWyngaert JK. Positioning During Radiotherapy for Breast Cancer—Reply. JAMA. 2013;309(2):137. doi:10.1001/jama.2012.56923