Breast Volume Is a Predictor of Higher Heart Dose in Whole-Breast Supine Free-Breathing Volumetric-Modulated Arc Therapy Planning-Reference-Cited by-同舟云学术

Breast Volume Is a Predictor of Higher Heart Dose in Whole-Breast Supine Free-Breathing Volumetric-Modulated Arc Therapy Planning

Published:2023-12-18 Issue:12 Volume:30 Page:10530-10538
ISSN:1718-7729
Container-title:Current Oncology
language:en
Short-container-title:Current Oncology

Author:

Alaimo Rita¹^ORCID,Ippolito Edy¹²^ORCID,Falconi Rita³,Perrone Congedi Francesca¹,Sciommari Cecilia¹,Silipigni Sonia¹,Pellegrini Roberto⁴^ORCID,Carnevale Alessia¹,Greco Carlo¹²,Fiore Michele¹²^ORCID,D’Angelillo Rolando M.⁵,Ramella Sara¹²

Affiliation:

1. Radiation Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy

2. Department of Radiation Oncology (Medicine and Surgery), Università Campus Bio-Medico di Roma, 00128 Rome, Italy

3. Medical Physics Unit, S. Filippo Neri Hospital, ASL Roma 1, 00135 Rome, Italy

4. Elekta AB, 113 57 Stockholm, Sweden

5. Radiation Oncology, Tor Vergata University, 00133 Rome, Italy

Abstract

In breast cancer volumetric-modulated arc therapy (VMAT) planning, the rotation of the gantry around the target implies a greater dose spreading to the whole heart, compared to tangential-field standard treatment. A consecutive cohort of 121 breast cancer patients treated with the VMAT technique was investigated. The correlation of breast volume, heart volume and lung volume with mean heart dose (mHD) and mean and maximum LAD dose (mLAD dose, MLAD dose) was tested, and a subsequent a linear regression analysis was carried out. VMAT treatment plans from 56 left breast cancer and 65 right breast cancer patients were analyzed. For right-sided patients, breast volume was significantly correlated with mHD, mLAD and MLAD dose, while for left-sided patients, breast volume was significantly correlated with mHD and mLAD, while heart volume and lung volume were correlated with mHD, mLAD and MLAD dose. Breast volume was the only predictor of increased heart and LAD dose (p ≤ 0.001) for right-sided patients. In left-sided patients, heart and lung were also predictors of increased mHD (p = 0.005, p ≤ 0.001) and mean LAD dose (p = 0.009, p ≤ 0.001). In this study, we observed an increase in heart and LAD doses in larger-breasted patients treated with VMAT planning. In right-sided patients, breast volume was shown to be the only predictor of increased heart dose and LAD dose.

Publisher

MDPI AG

Link

https://www.mdpi.com/1718-7729/30/12/768/pdf

Reference30 articles.

1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Darby, S., McGale, P., Correa, C., Taylor, C., Arriagada, R., Clarke, M., Cutter, D., Davies, C., and Ewertz, M. (2011). Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: Meta-analysis of individual patient data for 10,801 women in 17 randomized trials. Lancet, 378, 1707–1716.

2. Contemporary Breast Radiotherapy and Cardiac Toxicity;Yeboa;Semin. Radiat. Oncol.,2016

3. Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer;Darby;N. Engl. J. Med.,2013

4. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomized trials;Clarke;Lancet,2005

5. Dell’Oro, M., Giles, E., Sharkey, A., Borg, M., Connell, C., and Bezak, E. (2019). A Retrospective Dosimetric Study of Radiotherapy Patients with Left-Sided Breast Cancer; Patient Selection Criteria for Deep Inspiration Breath Hold Technique. Cancers, 11.