scholarly journals Developing Multivariable Normal Tissue Complication Probability Model to Predict the Incidence of Symptomatic Radiation Pneumonitis among Breast Cancer Patients

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0131736 ◽  
Author(s):  
Tsair-Fwu Lee ◽  
Pei-Ju Chao ◽  
Liyun Chang ◽  
Hui-Min Ting ◽  
Yu-Jie Huang
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Normal Tissue ◽  
Radiation Pneumonitis ◽  
Probability Model ◽  
Normal Tissue Complication Probability ◽  
Breast Cancer Patients

scholarly journals Developing of predictive models for pneumonitis with forward variable selection and LASSO logistic model for breast cancer patients treated with 3D-CRT

2018 ◽  
Vol 24 (4) ◽  
pp. 149-156 ◽  
Author(s):  
Maede Hasan Abdali ◽  
Karim Khoshgard ◽  
Abdolazim Sedighi Pashaki
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Lung Volume ◽  
Probability Model ◽  
Pulmonary Function Tests ◽  
Normal Tissue Complication Probability ◽  
Breast Cancer Patients ◽  
Predictive Parameters ◽  
Mean Lung Dose ◽  
3D Crt

Abstract Purpose: To develop a multiple logistic regression model as normal tissue complication probability model by least absolute shrinkage and selection operator (LASSO) technique in breast cancer patients treated with three-dimensional conformal radiation therapy (3D-CRT), we focused on the changes of pulmonary function tests to achieve the optimal predictive parameters for the occurrence of symptomatic radiation pneumonitis (SRP). Materials and methods: Dosimetric and spirometry data of 60 breast cancer patients were analyzed. Pulmonary function tests were done before RT, after completion of RT, 3, and 6 months after RT. Multiple logistic regression model was used to obtain the effective predictive parameters. Forward selection method was applied in NTCP model to determine the effective risk factors from obtained different parameters. Results: Symptomatic radiation pneumonitis was observed in five patients. Significant changes in pulmonary parameters have been observed at six months after RT. The parameters of mean lung dose (MLD), bridge separation (BS), mean irradiated lung volume (ILVmean), and the percentage of the ipsilateral lung volume that received dose of 20 Gy (IV20) introduced as risk factors using the LASSO technique for SRP in a multiple normal tissue complication probability model in breast cancer patients treated with 3D-CRT. The BS, central lung distance (CLD) and ILV in tangential field have obtained as 23.5 (20.9-26.0) cm, 2.4 (1.5-3.3) cm, and 12.4 (10.6-14.3) % of lung volume in radiation field in patients without pulmonary complication, respectively. Conclusion: The results showed that if BS, CLD, and ILV are more than 23 cm, 2 cm, and 12%, respectively, so incidence of SRP in the patients will be considerable. Our multiple NTCP LASSO model for breast cancer patients treated with 3D-CRT showed that in order to have minimum probability of SRP occurrence, parameters of BS, IV20, ILV and especially MLD would be kept in minimum levels. Considering dose-volume histogram, the mean lung dose factor is most important parameter which minimizing it in treatment planning, minimizes the probability of SRP and consequently improves the quality of life in breast cancer patients.

scholarly journals Dose Distribution in the Heart and Cardiac Chambers following 4-field Radiation Therapy of Breast Cancer: a Retrospective Study

2013 ◽  
Vol 7 ◽  
pp. BCBCR.S11118 ◽  
Author(s):  
Safora Johansen ◽  
Kristin H. Tjessem ◽  
Kristian Fosså ◽  
Gerhard Bosse ◽  
Turi Danielsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Normal Tissue Complication Probability ◽  
Radiation Doses ◽  
Breast Cancer Patients ◽  
Heart Volume ◽  
Volume Percentage ◽  
Dose Volume Histograms ◽  
Field Radiation ◽  
Whole Heart

Purpose To evaluate cardiac doses in breast cancer patients with stage II/III treated with 4-field radiotherapy based on computed tomography (CT) dose planning. Methods and Materials Based on archived CT images, whole heart and cardiac chamber radiation doses were analyzed in 216 (111 left-sided and 105 right-sided) mastectomized or lumpectomized breast cancer patients treated at a single institution, the Norwegian Radium Hospital, between 2000–2002. Individual dose volume histograms for the whole heart and for the four cardiac chambers were obtained, and mean, median and maximum doses to these structures were calculated. The dose (Gy) delivered to the 5% of the volume of each cardiac structure (D5%), and the volume percentage of each structure receiving ≥ 25 Gy (V25Gy) were reported. Normal tissue complication probability (NTCP) calculations were used to estimate the risk for ischemic heart disease (IHD). Results Cohort-based medians of the whole heart mean dose (Dmean) for left- and right-sided tumors were 3.2 Gy and 1.3 Gy, respectively, with similar ventricular but lower atrial values. The atrial doses did not differ according to laterality of the breast tumor. In 13 patients with left-sided cancer, 5% of the heart volume was exposed to >25 Gy. The NTCP estimates were generelly low, with a maximum of 2.8%. Conclusions During adjuvant CT-based locoregional radiotherapy of women with breast cancer, the cardiac radiation doses are, at the group level, below recommended threshold values (D5% < 25 Gy), though individual patients with left-sided disease may exceed these limits.

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