scholarly journals Dosimetric comparison and TCP-NTCP modelling for lung, heart, left anterior descending and right coronary artery in left sided breast cancer conventional and hypofractionated radiotherapy

2021 ◽  
Author(s):  
Hossein Taheri ◽  
Ali Akhavan ◽  
Mohammadbagher Tavakoli ◽  
Reza Moghareabed ◽  
Mahsa Kianinia
Keyword(s):  
Breast Cancer ◽  
Treatment Time ◽  
Good Alternative ◽  
Tumor Control ◽  
Tumor Control Probability ◽  
Breast Cancer Patients ◽  
Ipsilateral Lung ◽  
Internal Mammary ◽  
Ct Simulation ◽  
3D Crt

Abstract BackgroundThe aim of this study was to evaluate the dose distribution, and also tumor control probability (TCP) and normal tissue complications probability (NTCP) models of left sided breast cancer females for 3D-CRT, 6 and 9 fields IMRT and hypofractionated tangential plans.MethodsSixty left sided breast cancer females were included in this study. CT simulation images of the patients were imported on the treatment planning software (TiGRT, LinaTech, China), and the tangential treatment plans of the mentioned methods were done for each patient. The dosimetric evaluation, and TCP-NTCP models of stated modalities were done using Poisson Linear-Quadatric (PLQ) and Lyman-Kutcher-Burman (LKB) models on the MATLAB and R softwares.ResultsThe mean (± SD) dose to ipsilateral lung, heart, LAD and RCA with/without internal mammary fields for 6FIMRT was lower compared to other modalities. Furthermore, V20Gy for Ipsilateral lung and V25Gy for heart, LAD and RCA of 6FIMRT was lower than other methods. In addition, the PTV dose coverage was higher for 9FIMRT and hypofractionated RT, while it may be lower for 3D-CRT among the studied methods. Although TCP values of 9 and 6fieds and hypofractionated was not significantly different, the TCPs of them were higher compared to 3D-CRT. However, the NTCP for ipsilateral lung, heart, LAD and RCA of 6FIMRT was lower than others.Conclusion6FIMRT is suitable choice for RT of breast cancer patients compared to other mentioned modalities, as a result of providing adequate PTV dose coverage and TCP, and also lower imposed dose and NTCP for OARs. Hypofractionated RT is a good alternative to reduce treatment time for the breast cancer patients.Trial registrationThis study was approved by the ethical board of Isfahan University of Medical Sciences, Isfahan, Iran (IR.MUI.MED.REC.1399.677).

Internal Mammary Nodes in Breast Cancer: Diagnosis and Implications for Patient Management—A Systematic Review

2008 ◽  
Vol 26 (30) ◽  
pp. 4981-4989 ◽  
Author(s):  
Ronald C. Chen ◽  
Nancy U. Lin ◽  
Mehra Golshan ◽  
Jay R. Harris ◽  
Jennifer R. Bellon
Keyword(s):  
Breast Cancer ◽  
Survival Benefit ◽  
Randomized Trials ◽  
Radical Mastectomy ◽  
Tumor Control ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Cardiac Morbidity ◽  
Internal Mammary Nodes ◽  
Internal Mammary

The management of internal mammary nodes (IMNs) in breast cancer is controversial. Surgical series from the 1950s showed that one third of breast cancer patients had IMN involvement, with a higher risk in patients with medial tumors and/or positive axillary nodes. IMN metastasis has similar prognostic importance as axillary nodal involvement. However, after three randomized trials showed no survival benefit from extended mastectomy compared with radical or modified radical mastectomy, IMN dissection was largely abandoned. Recently, lymphoscintigraphy studies have renewed interest in IMN evaluation. Approximately one fifth of internal mammary sentinel nodes are pathologic, although most centers do not perform IMN biopsies because of concerns about morbidity and lack of established survival benefit. In addition, results from randomized trials testing the value of postmastectomy irradiation and a meta-analysis of 78 randomized trials have provided high levels of evidence that local-regional tumor control is associated with long-term survival improvements. This benefit was limited to trials that used systemic therapy, which was not routinely administered in the earlier surgical studies, although the contribution from IMN treatment is unclear. IMN irradiation has also been shown to cause increased cardiac morbidity. Before mature results from current randomized trials assessing the benefit of IMN irradiation become available, lymphoscintigraphy may be used to help guide decisions regarding systemic and local-regional treatment. However, even in patients with visualized primary IMN drainage, the potential benefit of treatment should be balanced against the risk of added morbidity.

Should the Hunt for Internal Mammary Chain Sentinel Nodes Begin? An Evaluation of 150 Breast Cancer Patients

2003 ◽  
Vol 10 (8) ◽  
pp. 935-941 ◽  
Author(s):  
Susanne H. Estourgie ◽  
Pieter J. Tanis ◽  
Omgo E. Nieweg ◽  
Renato A. Valdés Olmos ◽  
Emiel J. Th. Rutgers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Internal Mammary Chain ◽  
Sentinel Nodes ◽  
Internal Mammary

Internal Mammary Chain Sentinel Nodes in Early-Stage Breast Cancer Patients: Toward Selective Removal

2018 ◽  
Vol 26 (4) ◽  
pp. 945-953 ◽  
Author(s):  
Ariane A. van Loevezijn ◽  
Sanne A. L. Bartels ◽  
Frederieke H. van Duijnhoven ◽  
Wilma D. Heemsbergen ◽  
Sophie C. J. Bosma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Stage ◽  
Selective Removal ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Internal Mammary Chain ◽  
Sentinel Nodes ◽  
Internal Mammary

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 Dosimetric Comparison of Three Radiotherapy Techniques in Irradiation of Left-Sided Breast Cancer Patients after Radical Mastectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jian Hu ◽  
Guang Han ◽  
Yu Lei ◽  
Ximing Xu ◽  
Wei Ge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Target Volume ◽  
Conformity Index ◽  
Breast Cancer Patients ◽  
Ipsilateral Lung ◽  
Significant Difference

Introduction. This study is aimed at evaluating the dosimetric differences among target segmented planning (TSP), conventional 9-field intensity modulated radiation therapy (9FIMRT) planning, and volumetric modulated arc therapy (VMAT) planning for postmastectomy radiotherapy of left-sided breast cancer patients. Material and Methods. Fifteen left-sided breast cancer patients who underwent radical mastectomy were enrolled. In TSP, the planning target volume (PTV) was divided into four regions (supra/infraclavicular, chest wall, external mammary region, and internal mammary region), and each individual PTV region was treated with respective fixed fields. Results. The VMAT plans showed superior to PTV dose conformity index (CI), homogeneity index (HI), protection of the ipsilateral lung, monitor units (MUs), and maximum dose (Dmax) to the contralateral breast compared with TSP and 9FIMRT plans. The TSP provided better protection for Dmean of the heart and left ventricle (p<0.05). A dose for left anterior descending artery from the three techniques had no significant difference. Compared with the 9FIMRT plans, the V5Gy (%) and V10Gy (%) for the ipsilateral lung were significantly reduced with TSP and VMAT (p<0.05). The V5Gy (%) and V10Gy (%) for the ipsilateral lung turned out to be similar between VMAT and TSP techniques. Conclusions. Our study indicates that VMAT should be a better choice of radiotherapy for left-sided breast cancer patients after radical mastectomy. If VMAT is unavailable, 9FIMRT can achieve better CI and HI values and be more MU-efficient compared with TSP; however, TSP can effectively reduce the low dose volume of the ipsilateral lungs and heart.

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