open access

Vol 23, No 2 (2018)
Original research articles
Published online: 2018-03-01
Submitted: 2017-10-16
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Dosimetry of the left anterior descending coronary artery in left breast cancer patients treated with postoperative external radiotherapy

Adela Poitevin-Chacón, Jessica Chávez-Nogueda, Rubí Ramos Prudencio, Alejandro Calvo Fernández, Alejandro Rodríguez Laguna, Jesús Linares, Julio César Martínez
DOI: 10.1016/j.rpor.2018.01.003
·
Rep Pract Oncol Radiother 2018;23(2):91-96.

open access

Vol 23, No 2 (2018)
Original research articles
Published online: 2018-03-01
Submitted: 2017-10-16

Abstract

Aim

To evaluate the dose distribution to the left anterior descending (LAD) coronary artery in patients treated with postoperative three-dimensional conformal radiotherapy (3DCRT).

Background

Postoperative radiotherapy may increase the risk of heart disease, particularly in patients with left-sided breast cancer. Clinical data on doses to the LAD are limited.

Materials and methods

Retrospective study of 14 patients who underwent postoperative 3DCRT for left breast cancer in 2014. All data were retrieved from medical records. Means, medians, ranges, and percentages were calculated.

Results

The mean dose to the LAD in patients with V25[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]1% was 0.12[[ce:hsp sp="0.25"/]]cGy. Dmean, Dmax and V25 to the heart were, respectively, 3.7[[ce:hsp sp="0.25"/]]Gy (range, 0.9–4.18), 40.3[[ce:hsp sp="0.25"/]]Gy (9.28–62.9), and 1.59[[ce:hsp sp="0.25"/]]cGy. The mean Dmean and Dmax values in the sample were 9.71[[ce:hsp sp="0.25"/]]Gy and 33.2[[ce:hsp sp="0.25"/]]Gy, respectively. The maximum dose to the LAD (D2%) ranged from 3.66 to 53.01[[ce:hsp sp="0.25"/]]Gy. Due to the spacing of the CT slices (5[[ce:hsp sp="0.25"/]]mm), it was not possible to completely contour the entire artery. The mean dose to the heart (3.3[[ce:hsp sp="0.25"/]]Gy) was considered acceptable.

Conclusions

The maximum dose to the LAD was as high as 53[[ce:hsp sp="0.25"/]]Gy, suggesting an increased risk of cardiac morbidity. This study underscores the value of contouring the LAD and the value of the breath hold technique to reduce maximum cardiac doses. Smaller CT cuts (2.5[[ce:hsp sp="0.25"/]]mm) can improve contouring. Larger studies with long-term follow up are needed to determine the radiation tolerance dose for the LAD.

Abstract

Aim

To evaluate the dose distribution to the left anterior descending (LAD) coronary artery in patients treated with postoperative three-dimensional conformal radiotherapy (3DCRT).

Background

Postoperative radiotherapy may increase the risk of heart disease, particularly in patients with left-sided breast cancer. Clinical data on doses to the LAD are limited.

Materials and methods

Retrospective study of 14 patients who underwent postoperative 3DCRT for left breast cancer in 2014. All data were retrieved from medical records. Means, medians, ranges, and percentages were calculated.

Results

The mean dose to the LAD in patients with V25[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]1% was 0.12[[ce:hsp sp="0.25"/]]cGy. Dmean, Dmax and V25 to the heart were, respectively, 3.7[[ce:hsp sp="0.25"/]]Gy (range, 0.9–4.18), 40.3[[ce:hsp sp="0.25"/]]Gy (9.28–62.9), and 1.59[[ce:hsp sp="0.25"/]]cGy. The mean Dmean and Dmax values in the sample were 9.71[[ce:hsp sp="0.25"/]]Gy and 33.2[[ce:hsp sp="0.25"/]]Gy, respectively. The maximum dose to the LAD (D2%) ranged from 3.66 to 53.01[[ce:hsp sp="0.25"/]]Gy. Due to the spacing of the CT slices (5[[ce:hsp sp="0.25"/]]mm), it was not possible to completely contour the entire artery. The mean dose to the heart (3.3[[ce:hsp sp="0.25"/]]Gy) was considered acceptable.

Conclusions

The maximum dose to the LAD was as high as 53[[ce:hsp sp="0.25"/]]Gy, suggesting an increased risk of cardiac morbidity. This study underscores the value of contouring the LAD and the value of the breath hold technique to reduce maximum cardiac doses. Smaller CT cuts (2.5[[ce:hsp sp="0.25"/]]mm) can improve contouring. Larger studies with long-term follow up are needed to determine the radiation tolerance dose for the LAD.

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Keywords

Breast neoplasms; Breath holding; Coronary vessels; Radiation tolerance; Conformal radiotherapy

About this article
Title

Dosimetry of the left anterior descending coronary artery in left breast cancer patients treated with postoperative external radiotherapy

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 2 (2018)

Pages

91-96

Published online

2018-03-01

DOI

10.1016/j.rpor.2018.01.003

Bibliographic record

Rep Pract Oncol Radiother 2018;23(2):91-96.

Keywords

Breast neoplasms
Breath holding
Coronary vessels
Radiation tolerance
Conformal radiotherapy

Authors

Adela Poitevin-Chacón
Jessica Chávez-Nogueda
Rubí Ramos Prudencio
Alejandro Calvo Fernández
Alejandro Rodríguez Laguna
Jesús Linares
Julio César Martínez

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