Evaluation of dose to cardiac structures during breast irradiation

Marianne Aznar, Stine Korreman, Anders N Pedersen, Gitte Fredberg Persson, Mirjana Josipovic, Lena Specht

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    Objective: Adjuvant radiotherapy for breast cancer can lead to late cardiac complications. The highest radiation doses are likely to be to the anterior portion of the heart, including the left anterior descending coronary artery (LAD). The purpose of this work was to assess the radiation doses delivered to the heart and the LAD in respiration-adapted radiotherapy of patients with left-sided breast cancer.

    Methods: 24 patients referred for adjuvant radiotherapy after breast-conserving surgery for left-sided lymph node positive breast cancer were evaluated. The whole heart, the arch of the LAD and the whole LAD were contoured. The radiation doses to all three cardiac structures were evaluated.

    Results: For 13 patients, the plans were acceptable based on the criteria set for all 3 contours. For seven patients, the volume of heart irradiated was well below the set clinical threshold whereas a high dose was still being delivered to the LAD. In 1 case, the dose to the LAD was low while 19% of the contoured heart volume received over 20 Gy. In five patients, the dose to the arch LAD was relatively low while the dose to the whole LAD was considerably higher.

    Conclusion: This study indicates that it is necessary to assess the dose delivered to the whole heart as well as to the whole LAD when investigating the acceptability of a breast irradiation treatment. Assessing the dose to only one of these structures could lead to excessive heart irradiation and thereby increased risk of cardiac complications for breast cancer radiotherapy patients.
    OriginalsprogEngelsk
    TidsskriftBritish Journal of Radiology
    Vol/bind84
    Udgave nummer1004
    Sider (fra-til)743-746
    ISSN0007-1285
    DOI
    StatusUdgivet - 2011

    Citer dette

    Aznar, M., Korreman, S., Pedersen, A. N., Persson, G. F., Josipovic, M., & Specht, L. (2011). Evaluation of dose to cardiac structures during breast irradiation. British Journal of Radiology, 84(1004), 743-746. https://doi.org/10.1259/bjr/12497075
    Aznar, Marianne ; Korreman, Stine ; Pedersen, Anders N ; Persson, Gitte Fredberg ; Josipovic, Mirjana ; Specht, Lena. / Evaluation of dose to cardiac structures during breast irradiation. I: British Journal of Radiology. 2011 ; Bind 84, Nr. 1004. s. 743-746.
    @article{6df2a737c72644ba9cb30abebdff8df5,
    title = "Evaluation of dose to cardiac structures during breast irradiation",
    abstract = "Objective: Adjuvant radiotherapy for breast cancer can lead to late cardiac complications. The highest radiation doses are likely to be to the anterior portion of the heart, including the left anterior descending coronary artery (LAD). The purpose of this work was to assess the radiation doses delivered to the heart and the LAD in respiration-adapted radiotherapy of patients with left-sided breast cancer. Methods: 24 patients referred for adjuvant radiotherapy after breast-conserving surgery for left-sided lymph node positive breast cancer were evaluated. The whole heart, the arch of the LAD and the whole LAD were contoured. The radiation doses to all three cardiac structures were evaluated. Results: For 13 patients, the plans were acceptable based on the criteria set for all 3 contours. For seven patients, the volume of heart irradiated was well below the set clinical threshold whereas a high dose was still being delivered to the LAD. In 1 case, the dose to the LAD was low while 19{\%} of the contoured heart volume received over 20 Gy. In five patients, the dose to the arch LAD was relatively low while the dose to the whole LAD was considerably higher. Conclusion: This study indicates that it is necessary to assess the dose delivered to the whole heart as well as to the whole LAD when investigating the acceptability of a breast irradiation treatment. Assessing the dose to only one of these structures could lead to excessive heart irradiation and thereby increased risk of cardiac complications for breast cancer radiotherapy patients.",
    author = "Marianne Aznar and Stine Korreman and Pedersen, {Anders N} and Persson, {Gitte Fredberg} and Mirjana Josipovic and Lena Specht",
    year = "2011",
    doi = "10.1259/bjr/12497075",
    language = "English",
    volume = "84",
    pages = "743--746",
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    Aznar, M, Korreman, S, Pedersen, AN, Persson, GF, Josipovic, M & Specht, L 2011, 'Evaluation of dose to cardiac structures during breast irradiation', British Journal of Radiology, bind 84, nr. 1004, s. 743-746. https://doi.org/10.1259/bjr/12497075

    Evaluation of dose to cardiac structures during breast irradiation. / Aznar, Marianne; Korreman, Stine; Pedersen, Anders N; Persson, Gitte Fredberg; Josipovic, Mirjana; Specht, Lena.

    I: British Journal of Radiology, Bind 84, Nr. 1004, 2011, s. 743-746.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Evaluation of dose to cardiac structures during breast irradiation

    AU - Aznar, Marianne

    AU - Korreman, Stine

    AU - Pedersen, Anders N

    AU - Persson, Gitte Fredberg

    AU - Josipovic, Mirjana

    AU - Specht, Lena

    PY - 2011

    Y1 - 2011

    N2 - Objective: Adjuvant radiotherapy for breast cancer can lead to late cardiac complications. The highest radiation doses are likely to be to the anterior portion of the heart, including the left anterior descending coronary artery (LAD). The purpose of this work was to assess the radiation doses delivered to the heart and the LAD in respiration-adapted radiotherapy of patients with left-sided breast cancer. Methods: 24 patients referred for adjuvant radiotherapy after breast-conserving surgery for left-sided lymph node positive breast cancer were evaluated. The whole heart, the arch of the LAD and the whole LAD were contoured. The radiation doses to all three cardiac structures were evaluated. Results: For 13 patients, the plans were acceptable based on the criteria set for all 3 contours. For seven patients, the volume of heart irradiated was well below the set clinical threshold whereas a high dose was still being delivered to the LAD. In 1 case, the dose to the LAD was low while 19% of the contoured heart volume received over 20 Gy. In five patients, the dose to the arch LAD was relatively low while the dose to the whole LAD was considerably higher. Conclusion: This study indicates that it is necessary to assess the dose delivered to the whole heart as well as to the whole LAD when investigating the acceptability of a breast irradiation treatment. Assessing the dose to only one of these structures could lead to excessive heart irradiation and thereby increased risk of cardiac complications for breast cancer radiotherapy patients.

    AB - Objective: Adjuvant radiotherapy for breast cancer can lead to late cardiac complications. The highest radiation doses are likely to be to the anterior portion of the heart, including the left anterior descending coronary artery (LAD). The purpose of this work was to assess the radiation doses delivered to the heart and the LAD in respiration-adapted radiotherapy of patients with left-sided breast cancer. Methods: 24 patients referred for adjuvant radiotherapy after breast-conserving surgery for left-sided lymph node positive breast cancer were evaluated. The whole heart, the arch of the LAD and the whole LAD were contoured. The radiation doses to all three cardiac structures were evaluated. Results: For 13 patients, the plans were acceptable based on the criteria set for all 3 contours. For seven patients, the volume of heart irradiated was well below the set clinical threshold whereas a high dose was still being delivered to the LAD. In 1 case, the dose to the LAD was low while 19% of the contoured heart volume received over 20 Gy. In five patients, the dose to the arch LAD was relatively low while the dose to the whole LAD was considerably higher. Conclusion: This study indicates that it is necessary to assess the dose delivered to the whole heart as well as to the whole LAD when investigating the acceptability of a breast irradiation treatment. Assessing the dose to only one of these structures could lead to excessive heart irradiation and thereby increased risk of cardiac complications for breast cancer radiotherapy patients.

    U2 - 10.1259/bjr/12497075

    DO - 10.1259/bjr/12497075

    M3 - Journal article

    VL - 84

    SP - 743

    EP - 746

    JO - British Journal of Radiology

    JF - British Journal of Radiology

    SN - 0007-1285

    IS - 1004

    ER -

    Aznar M, Korreman S, Pedersen AN, Persson GF, Josipovic M, Specht L. Evaluation of dose to cardiac structures during breast irradiation. British Journal of Radiology. 2011;84(1004):743-746. https://doi.org/10.1259/bjr/12497075