PO-1074 Is the mean heart dose the best predictor of cardiac toxicity after Hodgkin Lymphoma irradiation?

2021 ◽  
Vol 161 ◽  
pp. S894
Author(s):  
R. Moujahed ◽  
M. Ben Rejeb ◽  
S. Ghorbel ◽  
A. Hamdoun ◽  
Z. Naimi ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Cardiac Toxicity ◽  
Heart Dose ◽  
The Mean ◽  
Mean Heart Dose

scholarly journals Analysis of cardiac toxicity after definitive chemoradiotherapy for esophageal cancer using a biological dose–volume histogram

2020 ◽  
Vol 61 (2) ◽  
pp. 298-306
Author(s):  
Yuki Takeuchi ◽  
Yuji Murakami ◽  
Tsubasa Kameoka ◽  
Masanori Ochi ◽  
Nobuki Imano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Cardiac Toxicity ◽  
Dose Volume Histogram ◽  
Definitive Chemoradiotherapy ◽  
Heart Dose ◽  
Dose Volume ◽  
The Mean ◽  
Mean Heart Dose ◽  
The Relationship

Abstract This study aimed to evaluate the relationship between cardiac toxicity after definitive chemoradiotherapy (CRT) for esophageal cancer and the dose–volume histogram (DVH) of organs at risk (OARs) [using biological effective dose (BED)]. We analyzed the data of 83 patients with esophageal cancer treated using definitive CRT between 2001 and 2016. Furthermore, we evaluated pericardial effusion (PE) as a measure of cardiac toxicity. The median total irradiation dose was 60 (50.4–71) Gy. Symptomatic PE was observed in 12 (14%) patients. The heart and pericardium V5–V100-BED were significantly higher in patients with symptomatic PE than in those without symptomatic PE (heart: V5–V95-BED, P < 0.001; V100-BED, P = 0.0053, and pericardium: V5–V40-BED, V55–V95-BED, P < 0.001; V45–50-BED, V100-BED, P < 0.05, respectively). Receiver operating characteristic curve analysis showed that the dose–volume parameter of the pericardium and the heart that was most strongly associated with an adverse cardiac event was V80-BED, and the mean dose and the cut-off value were 27.38% and 61.7 Gy-BED, respectively. Multivariate analysis showed that the pericardium V80-BED and the mean heart dose-BED were risk factors for symptomatic PE (P < 0.001, respectively). We revealed the relationship between the irradiated dose of the OARs and symptomatic PE using a BED-based dose–volume histogram. Pericardium V80-BED and mean heart dose-BED were the most relevant risk factors for symptomatic PE.

scholarly journals OC-0384: Relationship of mean heart dose and cardiac substructure dose over evolving radiation techniques in Hodgkin lymphoma

2018 ◽  
Vol 127 ◽  
pp. S196-S197
Author(s):  
B. Hoppe ◽  
N.P. Mendenhall ◽  
J.E. Bates ◽  
C.G. Morris ◽  
S. Flampouri
Keyword(s):  
Hodgkin Lymphoma ◽  
Heart Dose ◽  
Mean Heart Dose ◽  
Relationship Of

scholarly journals Dose Volume Relationship in Estimating Cardiac Doses in Breast Cancer Radiotherapy

2020 ◽  
Author(s):  
Lucy Pattanayak ◽  
Swodeep Mohanty ◽  
Deepak Kumar Sahu ◽  
Tapas Kumar Dash ◽  
Itishree Priyadarsini
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Conformal Radiotherapy ◽  
Free Breathing ◽  
P Value ◽  
Carcinoma Breast ◽  
Heart Dose ◽  
Cardiac Dose ◽  
The Mean ◽  
Mean Heart Dose

Introduction: Radiation therapy is an integral part of adjuvant treatment for breast cancer which reduces local recurrence and significantly increases survival. But, radiation therapy also has the propensity to increase cardiac morbidity and mortality due to dose received by the heart which is more in left-sided breast cancer. Mean Heart dose and Maximum Heart Distance (MHD) are two parameters to study dose received by the heart. Aim: The purpose of this study was to determine individual doses received by the heart and to correlate MHD with the mean heart dose received by heart in carcinoma breast patients receiving radiotherapy. Materials and Methods: Ninety patients of histologically proven carcinoma breast who attended the Department of Radiotherapy, Acharya Harihar Regional Cancer, Cuttack from January 2017 to January 2019 were selected for a prospective observational study. All patients were treated with 3D Conformal Radiotherapy technique using free breathing multi slice Computed Tomography (CT) scans to contour target and vital organs. Parallel opposed tangential treatment plans were generated for each patient. Individual dose received by the heart and MHD was assessed for each case. SPSS version 21 used for statistical analysis. The Spearman’s Rho test was used for correlation of MHD with Mean heart dose. The Mann-Whitney U test was used for comparing mean of MHD in left-sided and right-sided breast cancer. The Independent t-test was used for comparing means of Mean heart dose in left-sided and right-sided breast cancer. A p-value <0.05 was considered as statistically significant. Results: The Mean Heart Dose was 4.63 Gy for left-sided breast carcinoma patients and 0.846 Gy for right-sided breast cancer and there was a significant difference (p<0.001). Mean MHD for left-sided breast cancer was 2.974 cm while for right-sided it was 0.017 cm, the difference was statistically significant (p-value <0.001). MHD also correlated positively with Mean Heart Dose with correlation coefficient of 0.849 and p-value <0.001. Conclusion: MHD and Mean Heart dose were significantly higher in left-sided breast cancer receiving radiotherapy. MHD was also found to be positively related to Mean Heart dose and therefore found to be an important predictor of cardiac dose. For right-sided breast carcinoma receiving radiotherapy, free breathing technique using 3-Dimensional Conformal Radiotherapy (3DCRT) will suffice in terms of cardiac dose.

scholarly journals Tomayto, tomahto: prescription dose and mean heart dose in evaluating the cardiac impact of involved-field radiation therapy for Hodgkin lymphoma survivors

2019 ◽  
Vol 58 (12) ◽  
pp. 1783-1785
Author(s):  
James E. Bates ◽  
Stella Flampouri ◽  
Richard T. Hoppe ◽  
Zuofeng Li ◽  
Nancy P. Mendenhall ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Hodgkin Lymphoma ◽  
Heart Dose ◽  
Field Radiation ◽  
Prescription Dose ◽  
Mean Heart Dose ◽  
Involved Field ◽  
Lymphoma Survivors

Simple Method to Estimate Mean Heart Dose From Hodgkin Lymphoma Radiation Therapy According to Simulation X-Rays

2015 ◽  
Vol 92 (1) ◽  
pp. 153-160 ◽  
Author(s):  
Frederika A. van Nimwegen ◽  
David J. Cutter ◽  
Michael Schaapveld ◽  
Annemarieke Rutten ◽  
Karen Kooijman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Hodgkin Lymphoma ◽  
X Rays ◽  
Simple Method ◽  
Heart Dose ◽  
Mean Heart Dose

scholarly journals An Innovative VMAT Technique for Left-sided Breast Cancer Patients With Postmastectomy Radiotherapy (PMRT) Evaluated by Ratio of Heart Volume in Tangent Line (RHVTL)

2021 ◽  
Author(s):  
Zhe Zhang ◽  
Daming Li ◽  
Feng Peng ◽  
ZhiBo Tan ◽  
PengFei Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Planning ◽  
Tangent Line ◽  
Planning Techniques ◽  
Heart Volume ◽  
Postmastectomy Radiotherapy ◽  
Heart Dose ◽  
Advanced Planning ◽  
The Mean ◽  
Mean Heart Dose

Abstract For patients with left-sided breast cancer (LBC), postmastectomy radiotherapy (PMRT) has been shown to improve the overall survival and many advanced planning techniques was adopted in PMRT. We aim to use an innovative VMAT technique to enhance the conformity of PTV and reduce the scattering dose of surrounding OARs, thereby reducing the long-term toxicity of the heart as well as ipsilateral lung (IL). The study further analyzes the more appropriate treatment planning techniques for personalized LBC patients with PMRT. 35 LBC patients were retrospectively selected undergoing PMRT. The PTV included lymph nodes, chest walls, excluding internal mammary nodes, where 95% of PTV receiving the prescription dose of 50Gy (2Gy/fraction) with three different techniques, VMAT, IMRT, Hybrid VMAT. Furthermore, the ratio of Heart Volume in Tangent line and heart volume (RHVTL) was proposed to evaluate the relative antonymy position between patient's heart and PTV, which hypothetically represents the complexity of treatment planning. The data from this study showed that for LBC patients undergoing PMRT, the CI from VMAT was 0.85 (IMRT and H-VMAT were 0.77 and 0.83), the heart D mean was 502.9cGy (IMRT and H-VMAT were 675.6cGy and 687cGy) and the V20 of IL was 21.3 as the lowest of the three techniques, but the dose of the contralateral breast (CB) and contralateral lung increased noticeably. In H-VMAT and IMRT, the mean heart dose was significantly related to RHVTL, with R-values of 0.911 and 0.892 respectively, while the values in VMAT was 0.613, thus the VMAT technique was relatively unaffected by the difficulty of treatment plan. For RHVTL values exceed than 0.06, the mean heart dose under VMAT technique raised by 98.7cGy compared to the RHVTL value of less than 0.06, but H-VMAT and IMRT increased by 233cGy and 261.58cGy individually. This study illustrates that separated fields and adjacent fields in VMAT technique obtained the optimal conformality and lowest doses of heart in three techniques for LBC with PMRT. Thus, based on the results of our preliminary study, the VMAT technique is highly recommended when RHVTL is exceeded 0.06.

Dosimetric evaluation of organs at risk to toxicities between multicatheter accelerated partial-breast irradiation and whole-breast external beam radiotherapy.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 94-94
Author(s):  
Tabitha Y Chan ◽  
Poh Wee Tan ◽  
Chek Wee Tan ◽  
Johann I Tang
Keyword(s):  
External Beam Radiotherapy ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Lung Dose ◽  
Ipsilateral Lung ◽  
Heart Dose ◽  
Peak Dose ◽  
The Mean ◽  
Mean Lung Dose ◽  
Mean Heart Dose

94 Background: This study aims to quantify the dosimetric reduction to the heart and lung when comparing Whole Breast External Beam Radiotherapy(WBEBRT) with Multicatheter Accelerated Partial Breast Irradiation(MCAPBI) for early stage left sided breast cancer. Methods: Planning CT data sets of 13 patients with left breast cancer receiving multicatheter brachytherapy post breast conserving surgery were used to create two independent treatment plans – WBEBRT prescribed to 50Gy/25fractions and MCAPBI prescribed to 34Gy/10fractions. Dose parameters for (i) heart, (ii) left anterior descending(LAD) artery and (iii) ipsilateral lung were calculated and compared between the two treatment modalities. Results: After adjusting for Equivalent Dose in 2Gy Fractions(EQD2), comparing MCAPBI with WBEBRT, the largest dose reduction was for the LAD artery whose point dose differed by a factor of 4.9. Although somewhat less pronounced, this was also true for the mean lung dose of the ipsilateral lung and mean heart dose with a factor of 3.8 and 2.1 respectively. Compared to WBEBRT, the mean MCAPBI heart D0.1cc (representing the dose received by the most highly exposed 0.1 cc of the risk organ, i.e. the dose peak) was significantly lower(16.43Gy vs 48.82Gy;p<0.01) as well as mean heart dose(MHD) was significantly lower(2.33Gy vs 4.85Gy; p<0.01). Similarly, mean point dose for MCAPBI LAD was significantly lower compared to WBEBRT(9.85Gy vs 47.92Gy; p<0.05). Peak dose and mean lung dose(MLD) for ipsilateral lung was also lower for MCAPBI compared to WBEBRT (Peak dose: 22.19Gy vs 50.45Gy(p<0.05); MLD: 2.31Gy vs 8.73Gy(p<0.05). Conclusions: Compared to WBEBRT, MCAPBI showed a significant reduction in radiation dose for the heart and lung. This may translate into better cardiac and pulmonary toxicities for patients undergoing MCAPBI.

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