<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0050_s_006_w2aab3b7b5b1b6b1aab1c16b1Aa"><h3>Background</h3><p>The aim of the study was to quantify planned doses to the heart and specific cardiac substructures in free-breathing adjuvant three-dimensional radiation therapy (3D-CRT) and tangential intensity modulated radiotherapy (t-IMRT) for left-sided node-negative breast cancer, and to assess the differences in planned doses to organs at risk according to patients’ individual anatomy, including breast volume.</p></sec><sec id="j_raon-2020-0050_s_007_w2aab3b7b5b1b6b1aab1c16b2Aa"><h3>Patients and methods</h3><p>In the study, the whole heart and cardiac substructures were delineated for 60 patients using cardiac atlas. For each patient, 3D-CRT and t-IMRT plans were generated. The prescribed dose was 42.72 Gy in 16 fractions. Patients were divided into groups with small, medium, and large clinical target volume (CTV). Calculated dose distributions were compared amongst the two techniques and the three different groups of CTV.</p></sec><sec id="j_raon-2020-0050_s_008_w2aab3b7b5b1b6b1aab1c16b3Aa"><h3>Results</h3><p>Mean absorbed dose to the whole heart (MWHD) (1.9 <italic>vs</italic>. 2.1 Gy, P &lt; 0.005), left anterior descending coronary artery mean dose (8.2 <italic>vs</italic>. 8.4 Gy, P &lt; 0.005) and left ventricle (LV) mean dose (3.0 <italic>vs</italic>. 3.2, P &lt; 0.005) were all significantly lower with 3D-CRT technique compared to t-IMRT. Apical (8.5 <italic>vs</italic>. 9.0, P &lt; 0.005) and anterior LV walls (5.0 <italic>vs</italic>. 5.4 Gy, P &lt; 0.005) received the highest mean dose (D<sub>mean</sub>). MWHD and LV-D<sub>mean</sub> increased with increasing CTV size regardless of the technique. Low MWHD values (&lt; 2.5 Gy) were achieved in 44 (73.3%) and 41 (68.3%) patients for 3D-CRT and t-IMRT techniques, correspondingly.</p></sec><sec id="j_raon-2020-0050_s_009_w2aab3b7b5b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>Our study confirms a considerable range of the planned doses within the heart for adjuvant 3D-CRT or t-IMRT in node-negative breast cancer. We observed differences in heart dosimetric metrics between the three groups of CTV size, regardless of the radiotherapy planning technique.</p></sec></abstract>

BackgroundThe aim of the study was to quantify planned doses to the heart and specific cardiac substructures in free-breathing adjuvant three-dimensional radiation therapy (3D-CRT) and tangential intensity modulated radiotherapy (t-IMRT) for left-sided node-negative breast cancer, and to assess the differences in planned doses to organs at risk according to patients’ individual anatomy, including breast volume.Patients and methodsIn the study, the whole heart and cardiac substructures were delineated for 60 patients using cardiac atlas. For each patient, 3D-CRT and t-IMRT plans were generated. The prescribed dose was 42.72 Gy in 16 fractions. Patients were divided into groups with small, medium, and large clinical target volume (CTV). Calculated dose distributions were compared amongst the two techniques and the three different groups of CTV.ResultsMean absorbed dose to the whole heart (MWHD) (1.9 vs. 2.1 Gy, P < 0.005), left anterior descending coronary artery mean dose (8.2 vs. 8.4 Gy, P < 0.005) and left ventricle (LV) mean dose (3.0 vs. 3.2, P < 0.005) were all significantly lower with 3D-CRT technique compared to t-IMRT. Apical (8.5 vs. 9.0, P < 0.005) and anterior LV walls (5.0 vs. 5.4 Gy, P < 0.005) received the highest mean dose (Dmean). MWHD and LV-Dmean increased with increasing CTV size regardless of the technique. Low MWHD values (< 2.5 Gy) were achieved in 44 (73.3%) and 41 (68.3%) patients for 3D-CRT and t-IMRT techniques, correspondingly.ConclusionsOur study confirms a considerable range of the planned doses within the heart for adjuvant 3D-CRT or t-IMRT in node-negative breast cancer. We observed differences in heart dosimetric metrics between the three groups of CTV size, regardless of the radiotherapy planning technique.

Breast size and dose to cardiac substructures in adjuvant three-dimensional conformal radiotherapy compared to tangential intensity modulated radiotherapy

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundThe aim of the study was to quantify planned doses to the heart and specific cardiac substructures in free-breathing adjuvant three-dimensional...

Breast size and dose to cardiac substructures in adjuvant three-dimensional conformal radiotherapy compared to tangential intensity modulated radiotherapy

Article Category: Research Article

Published Online: Sep 29, 2020

Page range: 470 - 479

Received: Mar 18, 2020

Accepted: May 10, 2020

DOI: https://doi.org/10.2478/raon-2020-0050

© 2020 Ivica Ratosa, Aljasa Jenko, Zeljko Sljivic, Maja Pirnat, Irena Oblak, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.