Cardiac Dose From Tangential Breast Cancer Radiotherapy in the Year 2006

Taylor, Carolyn; Povall, J.M.; McGale, Paul; Nisbet, Andrew; Dodwell, David; Smith, Jonathan; Darby, Sarah C.

doi:10.1016/j.ijrobp.2007.12.058

Cited by 211 publications

(161 citation statements)

References 25 publications

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“…Optimal positioning in our study decreased mean LAD-NTD mean from ~14Gy to 6Gy for WBI, and from ~4Gy to 1.5Gy for PBI. Reductions in dose of these magnitudes could be associated with a significant reduction in CVD (7). As atherosclerosis anywhere along the LAD could cause CVD, LAD max is a relevant additional variable.…”

Section: Cardiac Dosimetrymentioning

confidence: 99%

See 1 more Smart Citation

Prone versus supine positioning for whole and partial-breast radiotherapy: A comparison of non-target tissue dosimetry

Kirby

Evans

Donovan

et al. 2010

Radiotherapy and Oncology

151

133

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Section: Cardiac Dosimetrymentioning

confidence: 99%

“…Improvements in radiotherapy techniques have resulted in reduced normal-tissue doses (6), correlating with reduced non-breast-cancer-related mortality (2). Nonetheless doses to the heart, LAD and lung from current standard supine WBI remain significant (7).…”

Section: Introductionmentioning

confidence: 99%

Prone versus supine positioning for whole and partial-breast radiotherapy: A comparison of non-target tissue dosimetry

Kirby

Evans

Donovan

et al. 2010

Radiotherapy and Oncology

151

133

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“…In some studies, RT to the left breast is associated with higher risk of IHD than RT to the right breast, probably due to the localization of the heart [8,9]. Dosimetry studies have shown that the left anterior descending artery (LAD) receives the highest radiation doses [10,11] and a higher incidence of coronary artery stenosis in the LAD has also been shown after RT of left-sided BC [12,13].…”

Section: Introductionmentioning

confidence: 99%

“…The radiation tolerance for the coronary arteries may however be different from other cardiac structures, and there are no current models for normal tissue complication probability (NTCP) concerning coronary artery toxicity [14]. The radiation volumes and doses to the heart have changed during the last decades due to the development of new radiation techniques but radiation doses to the most anterior part of the heart may still be high [11,15].…”

Section: Introductionmentioning

confidence: 99%

Inter-observer variation in delineating the coronary arteries as organs at risk

Wennstig

Garmo

Hållström

et al. 2017

Radiotherapy and Oncology

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PurposeTo determine the inter-observer variation in delineating the coronary arteries as organs at risk (OARs) in breast cancer (BC) radiotherapy (RT) and how this variation affects the estimated coronary artery radiation dose. MethodDelineation of the left main and the left anterior descending coronary artery (LMCA and LAD), and the right coronary artery (RCA), by using the heart atlas by Feng et al, was performed by three radiation oncologists in 32 women who had received adjuvant RT for BC. Centres of the arteries were calculated and distances between artery centres were measured and the artery radiation doses were estimated. The intraclass correlation coefficient (ICC) was used to quantify the variability in doses. ResultsAlong the extent of RCA, the median distance between centres of arteries varied from 2 to 9 mm with similar patterns over pairs of oncologists. For the LMCA-LAD the median distance varied from 1 to 4 mm. The estimated maximum radiation doses showed an ICC variation from 0.82 to 0.97. ConclusionThe coronary arteries can be reliably identified and delineated as OARs in BC RT. The spatial variance is limited and the total variation in radiation dose is almost completely determined by the between patient variation.

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“…Available evidence, however, suggests that even in a small group of 20 patients, the mean heart dose can vary by a factor of two between patients. Moreover, the mean dose to the left anterior coronary artery can vary by a factor of ten between patients [18]. F For 26% of the patients with major coronary events, no relevant record could be found.…”

mentioning

confidence: 99%