Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time?
Objective:In this study, we aimed to review the heart and left coronary artery doses over the years in patients who received breast cancer radiotherapy (RT).Materials and Methods:A total of 436 breast cancer patients of 2 RT centers treated between the years 2010 and 2018 were included. The mean hea...
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2021-04-01
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| Series: | European Journal of Breast Health |
| Subjects: | |
| Online Access: |
http://www.eurjbreasthealth.com/archives/archive-detail/article-preview/were-we-able-to-reduce-cardiac-doses-in-breast-can/47124
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| _version_ | 1828024986062815232 |
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| author | Pelin Altınok Latif Korkmaz Ayse Altınok Nuran Beşe |
| author_facet | Pelin Altınok Latif Korkmaz Ayse Altınok Nuran Beşe |
| author_sort | Pelin Altınok |
| collection | DOAJ |
| description | Objective:In this study, we aimed to review the heart and left coronary artery doses over the years in patients who received breast cancer radiotherapy (RT).Materials and Methods:A total of 436 breast cancer patients of 2 RT centers treated between the years 2010 and 2018 were included. The mean heart doses (HeartDmean-HDM) and left coronary artery mean doses (LDM) were analyzed using nonparametric tests. The conventional RT (CRT) was 50 Gy/2 Gy in 5 weeks, and the hypofractionated RT (HRT) was 40.05 Gy/2.67 Gy in 3 weeks. Boost was applied as 10–16 Gy/2 Gy for CRT and 10 Gy/2.5 Gy for HRT. An equivalent conventional total dose of 2 Gy/fraction (EQD2) was taken into account for HRT.Results:HDM was 107±104 cGy, and LDM was 288±209 cGy for the entire group. HDM was significantly lower in patients with breast-conserving surgery (99±94 cGy) than that in those with mastectomy (128±124 cGy) (p<0.001). Field-in-field intensity-modulated RT technique significantly reduced the doses compared to volumetric applications (104±95 cGy vs 141±38 cGy; p = 0.002). HDM was significantly increased with lymphatic RT (132±58 cGy vs 112±115 cGy; p<0.001). The addition of internal mammary volumes significantly increased HDM (p<0.001). No significant effect of boost was observed (p = 0.96). For both CRT and HRT regimens, HDM values were significantly lower after the year 2014 (right side p<0.001, left side p = 0.01). In the left side CRT, HDM was 1.74 Gy before 2014 and 1.3 Gy after 2014 and 1.0 and 1.19 Gy, respectively, for the right side.Conclusion:All efforts to reduce the cardiac doses will likely reduce long-term side effects. |
| first_indexed | 2024-04-10T12:53:17Z |
| format | Article |
| id | doaj.art-e5f72749b446486bb685b6cae51d48db |
| institution | Directory Open Access Journal |
| issn | 2587-0831 |
| language | English |
| last_indexed | 2024-04-10T12:53:17Z |
| publishDate | 2021-04-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | European Journal of Breast Health |
| spelling | doaj.art-e5f72749b446486bb685b6cae51d48db2023-02-15T16:13:39ZengGalenos Publishing HouseEuropean Journal of Breast Health2587-08312021-04-0117214514910.4274/ejbh.galenos.2021.614813049054Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time?Pelin Altınok0Latif Korkmaz1Ayse Altınok2Nuran Beşe3 Department of Radiation Oncology, University of Health Sciences Turkey, Ümraniye Training and Research Hospital, İstanbul, Turkey Research Institute of Senology, Acıbadem Maslak Hospital, İstanbul, Turkey Research Institute of Senology, Acıbadem Maslak Hospital, İstanbul, Turkey Research Institute of Senology, Acıbadem Maslak Hospital, İstanbul, Turkey Objective:In this study, we aimed to review the heart and left coronary artery doses over the years in patients who received breast cancer radiotherapy (RT).Materials and Methods:A total of 436 breast cancer patients of 2 RT centers treated between the years 2010 and 2018 were included. The mean heart doses (HeartDmean-HDM) and left coronary artery mean doses (LDM) were analyzed using nonparametric tests. The conventional RT (CRT) was 50 Gy/2 Gy in 5 weeks, and the hypofractionated RT (HRT) was 40.05 Gy/2.67 Gy in 3 weeks. Boost was applied as 10–16 Gy/2 Gy for CRT and 10 Gy/2.5 Gy for HRT. An equivalent conventional total dose of 2 Gy/fraction (EQD2) was taken into account for HRT.Results:HDM was 107±104 cGy, and LDM was 288±209 cGy for the entire group. HDM was significantly lower in patients with breast-conserving surgery (99±94 cGy) than that in those with mastectomy (128±124 cGy) (p<0.001). Field-in-field intensity-modulated RT technique significantly reduced the doses compared to volumetric applications (104±95 cGy vs 141±38 cGy; p = 0.002). HDM was significantly increased with lymphatic RT (132±58 cGy vs 112±115 cGy; p<0.001). The addition of internal mammary volumes significantly increased HDM (p<0.001). No significant effect of boost was observed (p = 0.96). For both CRT and HRT regimens, HDM values were significantly lower after the year 2014 (right side p<0.001, left side p = 0.01). In the left side CRT, HDM was 1.74 Gy before 2014 and 1.3 Gy after 2014 and 1.0 and 1.19 Gy, respectively, for the right side.Conclusion:All efforts to reduce the cardiac doses will likely reduce long-term side effects. http://www.eurjbreasthealth.com/archives/archive-detail/article-preview/were-we-able-to-reduce-cardiac-doses-in-breast-can/47124 breast cancerradiotherapycardiac toxicity |
| spellingShingle | Pelin Altınok Latif Korkmaz Ayse Altınok Nuran Beşe Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time? European Journal of Breast Health breast cancer radiotherapy cardiac toxicity |
| title | Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time? |
| title_full | Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time? |
| title_fullStr | Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time? |
| title_full_unstemmed | Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time? |
| title_short | Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time? |
| title_sort | were we able to reduce cardiac doses in breast cancer radiotherapy over time |
| topic | breast cancer radiotherapy cardiac toxicity |
| url |
http://www.eurjbreasthealth.com/archives/archive-detail/article-preview/were-we-able-to-reduce-cardiac-doses-in-breast-can/47124
|
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