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.

scholarly journals Volume-based algorithm of lung dose optimization in novel dynamic arc radiotherapy for esophageal cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kuan-Heng Lin ◽  
Chen-Xiong Hsu ◽  
Shan-Ying Wang ◽  
Greta S. P. Mok ◽  
Chiu-Han Chang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Esophageal Cancer ◽  
Maximum Dose ◽  
Treatment Plan ◽  
Conformity Index ◽  
Lung Dose ◽  
Heart Dose ◽  
The Mean ◽  
Mean Lung Dose ◽  
Mean Heart Dose

AbstractThis study aims to develop a volume-based algorithm (VBA) that can rapidly optimize rotating gantry arc angles and predict the lung V5 preceding the treatment planning. This phantom study was performed in the dynamic arc therapy planning systems for an esophageal cancer model. The angle of rotation of the gantry around the isocenter as defined as arc angle (θA), ranging from 360° to 80° with an interval of 20°, resulting in 15 different θA of treatment plans. The corresponding predicted lung V5 was calculated by the VBA, the mean lung dose, lung V5, lung V20, mean heart dose, heart V30, the spinal cord maximum dose and conformity index were assessed from dose–volume histogram in the treatment plan. Correlations between the predicted lung V5 and the dosimetric indices were evaluated using Pearson’s correlation coefficient. The results showed that the predicted lung V5 and the lung V5 in the treatment plan were positively correlated (r = 0.996, p < 0.001). As the θA decreased, lung V5, lung V20, and the mean lung dose decreased while the mean heart dose, V30 and the spinal cord maximum dose increased. The V20 and the mean lung dose also showed high correlations with the predicted lung V5 (r = 0.974, 0.999, p < 0.001). This study successfully developed an efficient VBA to rapidly calculate the θA to predict the lung V5 and reduce the lung dose, with potentials to improve the current clinical practice of dynamic arc radiotherapy.

Method of predicting the mean lung dose based on a patient׳s anatomy and dose-volume histograms

2017 ◽  
Vol 42 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Anna Zawadzka ◽  
Marta Nesteruk ◽  
Beata Brzozowska ◽  
Paweł F. Kukołowicz
Keyword(s):  
Lung Dose ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
The Mean ◽  
Mean Lung Dose

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 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 &lt; 0.001; V100-BED, P = 0.0053, and pericardium: V5–V40-BED, V55–V95-BED, P &lt; 0.001; V45–50-BED, V100-BED, P &lt; 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 &lt; 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.

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