Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation

Background: Protecting cardiac function in patients with advanced left-breast cancer receiving radiation therapy (RT) with regional nodal irradiation (RNI) is an important issue. Modern RT techniques can limit cardiac exposure. The aim of this study was to explore the association be-tween cardiac do...

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Main Authors: Pei-Yu Hou, Chen-Hsi Hsieh, Le-Jung Wu, Chen-Xiong Hsu, Deng-Yu Kuo, Yueh-Feng Lu, Yen-Wen Wu, Hui-Ju Tien, Shih-Ming Hsu, Pei-Wei Shueng
Format: Article
Language:English
Published: MDPI AG 2022-05-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/9/5/213
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author Pei-Yu Hou
Chen-Hsi Hsieh
Le-Jung Wu
Chen-Xiong Hsu
Deng-Yu Kuo
Yueh-Feng Lu
Yen-Wen Wu
Hui-Ju Tien
Shih-Ming Hsu
Pei-Wei Shueng
author_facet Pei-Yu Hou
Chen-Hsi Hsieh
Le-Jung Wu
Chen-Xiong Hsu
Deng-Yu Kuo
Yueh-Feng Lu
Yen-Wen Wu
Hui-Ju Tien
Shih-Ming Hsu
Pei-Wei Shueng
author_sort Pei-Yu Hou
collection DOAJ
description Background: Protecting cardiac function in patients with advanced left-breast cancer receiving radiation therapy (RT) with regional nodal irradiation (RNI) is an important issue. Modern RT techniques can limit cardiac exposure. The aim of this study was to explore the association be-tween cardiac dose and cardiac function. Methods: Between 2017 and 2020, we retrospectively reviewed left-breast cancer patients who received adjuvant RT, including RNI with either volumetric-modulated arc therapy (VMAT) or helical tomotherapy (HT). Left ventricular ejection fraction (LVEF) was assessed by echocardiography before RT and 1 year after RT to detect any early deterioration in cardiac systolic function. Results: A total of 30 eligible patients were enrolled. The median follow-up time from the initiation of RT was 3.9 years (range 0.6–5 years). Seventeen patients received VMAT, and the other 13 patients received HT. The median RT dose was 55 Gray (Gy), and the mean heart dose was 3.73 Gy (range 1.95–9.36 Gy). The median LVEF before and after RT was 68% and 68.5%, respectively. No obvious deterioration was found. There was no association between cardiac dose (mean heart dose, V5–V30) and LVEF (change in values or post-RT). Conclusions: For left-breast cancer patients undergoing RT with RNI, VMAT, or HT can be used to limit cardiac exposure. Cardiac function as evaluated by LVEF revealed no obvious deterioration after RT in our patients, and no association was found between cardiac dose and LVEF in those treated with either VMAT or HT in early cardiac surveillance.
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spelling doaj.art-cc68fc76766a49d3be0a11dd2243faec2023-11-23T10:05:50ZengMDPI AGBioengineering2306-53542022-05-019521310.3390/bioengineering9050213Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal IrradiationPei-Yu Hou0Chen-Hsi Hsieh1Le-Jung Wu2Chen-Xiong Hsu3Deng-Yu Kuo4Yueh-Feng Lu5Yen-Wen Wu6Hui-Ju Tien7Shih-Ming Hsu8Pei-Wei Shueng9Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanDepartment of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, TaiwanDivision of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanBackground: Protecting cardiac function in patients with advanced left-breast cancer receiving radiation therapy (RT) with regional nodal irradiation (RNI) is an important issue. Modern RT techniques can limit cardiac exposure. The aim of this study was to explore the association be-tween cardiac dose and cardiac function. Methods: Between 2017 and 2020, we retrospectively reviewed left-breast cancer patients who received adjuvant RT, including RNI with either volumetric-modulated arc therapy (VMAT) or helical tomotherapy (HT). Left ventricular ejection fraction (LVEF) was assessed by echocardiography before RT and 1 year after RT to detect any early deterioration in cardiac systolic function. Results: A total of 30 eligible patients were enrolled. The median follow-up time from the initiation of RT was 3.9 years (range 0.6–5 years). Seventeen patients received VMAT, and the other 13 patients received HT. The median RT dose was 55 Gray (Gy), and the mean heart dose was 3.73 Gy (range 1.95–9.36 Gy). The median LVEF before and after RT was 68% and 68.5%, respectively. No obvious deterioration was found. There was no association between cardiac dose (mean heart dose, V5–V30) and LVEF (change in values or post-RT). Conclusions: For left-breast cancer patients undergoing RT with RNI, VMAT, or HT can be used to limit cardiac exposure. Cardiac function as evaluated by LVEF revealed no obvious deterioration after RT in our patients, and no association was found between cardiac dose and LVEF in those treated with either VMAT or HT in early cardiac surveillance.https://www.mdpi.com/2306-5354/9/5/213breast cancervolumetric-modulated arc therapyhelical tomotherapyregional nodal irradiationleft ventricular ejection fraction
spellingShingle Pei-Yu Hou
Chen-Hsi Hsieh
Le-Jung Wu
Chen-Xiong Hsu
Deng-Yu Kuo
Yueh-Feng Lu
Yen-Wen Wu
Hui-Ju Tien
Shih-Ming Hsu
Pei-Wei Shueng
Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation
Bioengineering
breast cancer
volumetric-modulated arc therapy
helical tomotherapy
regional nodal irradiation
left ventricular ejection fraction
title Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation
title_full Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation
title_fullStr Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation
title_full_unstemmed Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation
title_short Cardiac Function after Modern Radiation Therapy with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Advanced Left-Breast Cancer Receiving Regional Nodal Irradiation
title_sort cardiac function after modern radiation therapy with volumetric modulated arc therapy or helical tomotherapy for advanced left breast cancer receiving regional nodal irradiation
topic breast cancer
volumetric-modulated arc therapy
helical tomotherapy
regional nodal irradiation
left ventricular ejection fraction
url https://www.mdpi.com/2306-5354/9/5/213
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