Factors Affecting Heart and Anterior Descending Coronary Artery Radiation Dose during Left Breast Irradiation (Dosimetric Retrospective study)

Abstract

Background: Breast cancer is the commonest cancer in females. Radiotherapy is one of the important factors in treatment of breast cancer. Heart and coronary artery are radio-biologically serial organs. Radiation toxicity in the treatment of breast cancer showed significant clinical problem and increased cardiac morbidity and mortality. Aim of the Work: Assessing Factors affecting heart and anterior descending coronary artery dose during left breast irradiation in 3D technique. Patients and Methods: This study included 69 patients with left breast cancer received radiotherapy to the chest wall or breast tissue at Clinical Oncology Department, Al-Hussein University hospital. Results: heart size and Maximum heart distance included in tangential fled had a relation between mean of heart and ADCA. Heart size rang (442.4 -898.9) with mean 623±104 cm3 we found when heart size increase the mean dose to heart and ADCA decrease with significant p value 0.017 and 0.016 respectively. Maximum heart distance that when if it was ≤3cm, the mean of the ADCA was 18.5±10.9 Gy while when if it was >3cm, the mean of the ADCA was 27.9±9.1 Gy with a p-value 0.030 which is statistically significant. Conclusion: Maximum heart distance included in tangential field and Heart size were only Factors can Affect mean of Heart and ADCA Radiation Dose During Left Breast Irradiation while BSA, WT, BMI, HT, RTH dose, number of fractions, number of segments, para sternal tissue thickness, Breast Size, Shortest distance between heart and ANT chest wall, Site, Extent, Type surgery, Boost, Bolus and stage were insignificant.