Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses
Purpose: To assess sinoatrial node (SAN) and atrioventricular node (AVN) doses for breast cancer (BC) patients treated with 3D-CRT and evaluate whether “large” cardiac structures (whole heart and four cardiac chambers) would be relevant surrogates. Material and methods: This single center study was...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630822000994 |
| _version_ | 1811178735837118464 |
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| author | M.Y. Errahmani M. Locquet D. Broggio D. Spoor G. Jimenez J. Camilleri J.A. Langendijk A.P.G. Crijns M.O. Bernier J. Ferrières J. Thariat S. Boveda Y. Kirova P Loap V. Monceau S. Jacob |
| author_facet | M.Y. Errahmani M. Locquet D. Broggio D. Spoor G. Jimenez J. Camilleri J.A. Langendijk A.P.G. Crijns M.O. Bernier J. Ferrières J. Thariat S. Boveda Y. Kirova P Loap V. Monceau S. Jacob |
| author_sort | M.Y. Errahmani |
| collection | DOAJ |
| description | Purpose: To assess sinoatrial node (SAN) and atrioventricular node (AVN) doses for breast cancer (BC) patients treated with 3D-CRT and evaluate whether “large” cardiac structures (whole heart and four cardiac chambers) would be relevant surrogates. Material and methods: This single center study was based on 116 BCE patients (56 left-sided, 60 right-sided) treated with 3D-CRT without respiratory gating strategies and few IMN irradiations from 2009 to 2013. The heart, the left and right ventricles (LV, RV), the left and right atria (LA, RA) were contoured using multi-atlases for auto-segmentation. The SAN and the AVN were manually delineated using a specific atlas. Based on regression analysis, the coefficients of determination (R2) were estimated to evaluate whether “large” cardiac structures were relevant surrogates (R2 > 0.70) of SAN and AVN doses. Results: For left-sided BC, mean doses were: 3.60 ± 2.28 Gy for heart, 0.47 ± 0.24 Gy for SAN and 0.74 ± 0.29 Gy for AVN. For right-sided BC, mean heart dose was 0.60 ± 0.25 Gy, mean SAN dose was 1.57 ± 0.63 Gy (>85 % of patients with SAN doses > 1 Gy) and mean AVN dose was 0.51 ± 0.14 Gy. Among all “large” cardiac structures, RA appeared as the best surrogate for SAN doses (R2 > 0.80). Regarding AVN doses, the RA may also be an interesting surrogate for left-sided BC (R2 = 0.78), but none of “large” cardiac structures appeared as relevant surrogates among right-sided BC (all R2 < 0.70), except the LA for patients with IMN (R2 = 0.83). Conclusions: In BC patients treated 10 years ago with 3D-CRT, SAN and AVN exposure was moderate but could exceed 1 Gy to the SAN in many right-sided patients with no IMN-inclusion. The RA appeared as an interesting surrogate for SAN exposure. Specific conduction nodes delineation remains necessary by using modern radiotherapy techniques. |
| first_indexed | 2024-04-11T06:24:22Z |
| format | Article |
| id | doaj.art-a3973a6f47b146009e56d873431f2665 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-11T06:24:22Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-a3973a6f47b146009e56d873431f26652022-12-22T04:40:27ZengElsevierClinical and Translational Radiation Oncology2405-63082023-01-01386270Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers dosesM.Y. Errahmani0M. Locquet1D. Broggio2D. Spoor3G. Jimenez4J. Camilleri5J.A. Langendijk6A.P.G. Crijns7M.O. Bernier8J. Ferrières9J. Thariat10S. Boveda11Y. Kirova12P Loap13V. Monceau14S. Jacob15Laboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-Aux-Roses, France; University Paris-Saclay, Gif-sur-Yvette, FranceLaboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-Aux-Roses, FranceDepartment of Dosimetry, IRSN/PSE-SANTE/SDOS/LEDI, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-Aux-Roses, FranceDepartment of Radiation Oncology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the NetherlandsDepartment of Radiation Oncology (Oncorad), Clinique Pasteur, Toulouse, FranceDepartment of Radiation Oncology (Oncorad), Clinique Pasteur, Toulouse, FranceDepartment of Radiation Oncology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the NetherlandsDepartment of Radiation Oncology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the NetherlandsLaboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-Aux-Roses, FranceDepartment of Cardiology and INSERM UMR 1295 CERPOP, Rangueil University Hospital, Toulouse, FranceDepartment of Radiotherapy, Centre de Lutte Contre le Cancer A. Baclesse, University of Caen Normandie, Caen, FranceHeart Rhythm Management Department, Clinique Pasteur, Toulouse, FranceDepartment of Radiation Oncology, Institut Curie, Paris, FranceDepartment of Radiation Oncology, Institut Curie, Paris, FranceLaboratory of Radiotoxicology and Radiobiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-Aux-Roses, FranceLaboratory of Epidemiology, Institute for Radiation Protection and Nuclear Safety (IRSN), Fontenay-Aux-Roses, France; Corresponding author at: IRSN, PSE-SANTE, SESANE, LEPID, BP17, 92262 Fontenay-aux-Roses cedex, France.Purpose: To assess sinoatrial node (SAN) and atrioventricular node (AVN) doses for breast cancer (BC) patients treated with 3D-CRT and evaluate whether “large” cardiac structures (whole heart and four cardiac chambers) would be relevant surrogates. Material and methods: This single center study was based on 116 BCE patients (56 left-sided, 60 right-sided) treated with 3D-CRT without respiratory gating strategies and few IMN irradiations from 2009 to 2013. The heart, the left and right ventricles (LV, RV), the left and right atria (LA, RA) were contoured using multi-atlases for auto-segmentation. The SAN and the AVN were manually delineated using a specific atlas. Based on regression analysis, the coefficients of determination (R2) were estimated to evaluate whether “large” cardiac structures were relevant surrogates (R2 > 0.70) of SAN and AVN doses. Results: For left-sided BC, mean doses were: 3.60 ± 2.28 Gy for heart, 0.47 ± 0.24 Gy for SAN and 0.74 ± 0.29 Gy for AVN. For right-sided BC, mean heart dose was 0.60 ± 0.25 Gy, mean SAN dose was 1.57 ± 0.63 Gy (>85 % of patients with SAN doses > 1 Gy) and mean AVN dose was 0.51 ± 0.14 Gy. Among all “large” cardiac structures, RA appeared as the best surrogate for SAN doses (R2 > 0.80). Regarding AVN doses, the RA may also be an interesting surrogate for left-sided BC (R2 = 0.78), but none of “large” cardiac structures appeared as relevant surrogates among right-sided BC (all R2 < 0.70), except the LA for patients with IMN (R2 = 0.83). Conclusions: In BC patients treated 10 years ago with 3D-CRT, SAN and AVN exposure was moderate but could exceed 1 Gy to the SAN in many right-sided patients with no IMN-inclusion. The RA appeared as an interesting surrogate for SAN exposure. Specific conduction nodes delineation remains necessary by using modern radiotherapy techniques.http://www.sciencedirect.com/science/article/pii/S2405630822000994Breast cancerRadiation therapyConduction nodesArrhythmiasConduction disordersDosimetry |
| spellingShingle | M.Y. Errahmani M. Locquet D. Broggio D. Spoor G. Jimenez J. Camilleri J.A. Langendijk A.P.G. Crijns M.O. Bernier J. Ferrières J. Thariat S. Boveda Y. Kirova P Loap V. Monceau S. Jacob Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses Clinical and Translational Radiation Oncology Breast cancer Radiation therapy Conduction nodes Arrhythmias Conduction disorders Dosimetry |
| title | Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses |
| title_full | Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses |
| title_fullStr | Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses |
| title_full_unstemmed | Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses |
| title_short | Supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses |
| title_sort | supraventricular cardiac conduction system exposure in breast cancer patients treated with radiotherapy and association with heart and cardiac chambers doses |
| topic | Breast cancer Radiation therapy Conduction nodes Arrhythmias Conduction disorders Dosimetry |
| url | http://www.sciencedirect.com/science/article/pii/S2405630822000994 |
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