Impact de la radiothérapie thoracique sur les structures cardiaques

Eber, Jordan; Nannini, Simon; Chambrelant, Isabelle; Fèvre, C. Le; Noël, Georges; Antoni, D.

doi:10.1016/j.canrad.2021.08.022

Cited by 5 publications

(4 citation statements)

References 74 publications

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“…Cardiac substructures are not delineated in daily practice, mainly because MHD is widely considered the only dosimetric parameter to optimize. Recent studies have demonstrated that irradiation to specific cardiac substructures was significantly associated with distinctive cardiac adverse events [ 43 ]. In line with the previous literature, the results of this study confirmed that MHD is not the best relevant parameter for a full understanding of left-sided breast dosimetry, and MHD is insufficient to predict the individual patient dose to the LV and coronary arteries, especially the LADA [ 44 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Cardiac Substructures Exposure of DIBH-3DCRT, FB-HT, and FB-3DCRT in Hypofractionated Radiotherapy for Left-Sided Breast Cancer after Breast-Conserving Surgery: An In Silico Planning Study

Eber

Schmitt

Dehaynin

et al. 2023

Cancers

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Left-sided breast cancer radiotherapy can lead to late cardiovascular complications, including ischemic events. To mitigate these risks, cardiac-sparing techniques such as deep-inspiration breath-hold (DIBH) and intensity-modulated radiotherapy (IMRT) have been developed. However, recent studies have shown that mean heart dose is not a sufficient dosimetric parameter for assessing cardiac exposure. In this study, we aimed to compare the radiation exposure to cardiac substructures for ten patients who underwent hypofractionated radiotherapy using DIBH three-dimensional conformal radiation therapy (3DCRT), free-breathing (FB)-3DCRT, and FB helical tomotherapy (HT). Dosimetric parameters of cardiac substructures were analyzed, and the results were statistically compared using the Wilcoxon signed-rank test. This study found a significant reduction in the dose to the heart, left anterior descending coronary artery, and ventricles with DIBH-3DCRT and FB-HT compared to FB-3DCRT. While DIBH-3DCRT was very effective in sparing the heart, in some cases, it provided little or no cardiac sparing. FB-HT can be an interesting treatment modality to reduce the dose to major coronary vessels and ventricles and may be of interest for patients with cardiovascular risks who do not benefit from or cannot perform DIBH. These findings highlight the importance of cardiac-sparing techniques for precise delivery of radiation therapy.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Cardiac Substructures Exposure of DIBH-3DCRT, FB-HT, and FB-3DCRT in Hypofractionated Radiotherapy for Left-Sided Breast Cancer after Breast-Conserving Surgery: An In Silico Planning Study

Eber

Schmitt

Dehaynin

et al. 2023

Cancers

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“…Late toxicity is characterized by coronary stenosis and ischemic heart disease with a latency period of 10 years. Emphasis is added on the use of modern techniques and strict adherence to dosimetric recommendations 62,63 .…”

Section: Cardiac Toxicity and Cardioprotectionmentioning

confidence: 99%

Mexican breast cancer consensus. Multidisciplinary care in breast cancer

Soto-Pérez-de-Celis,

Aguilar-y-Méndez,

Allende-Pérez

et al. 2024

GAMO

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Breast cancer impacts various spheres of the patient's life and their family and social environment. It is a complex disease that requires a multidisciplinary approach both for diagnosis and treatment, as well as for managing mediate and late toxicity from systemic treatment and radiotherapy, as well as psychological aspects. Palliative care and pain management are being incorporated earlier and earlier into treatment for the benefit of patients. Geneticists have now been incorporated into this multidisciplinary approach due to advances in genotyping and targeted therapies. The dissemination of this consensus contributes to the updating and homogeneity of breast cancer management criteria and the objective of this article is to present the update on the multidisciplinary management of breast cancer.

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“…La toxicidad tardía se caracteriza por estenosis coronaria y cardiopatía isquémica con un periodo de latencia de 10 años. Énfasis añadido en el empleo de técnicas modernas y apego estricto a las recomendaciones dosimétricas 62,63 . liNFedema En pacientes sometidas a ganglio centinela y RT a pared torácica, la adición de RT ganglionar no aumenta el riesgo de linfedema.…”

Section: Toxicidad Cardiaca Y Cardioprotecciónunclassified

Consenso mexicano de cáncer mamario. Cuidados multidisciplinarios en cáncer de mama

Soto-Pérez-de-Celis,

Aguilar-y-Méndez,

Allende-Pérez

et al. 2024

GAMO

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El cáncer mamario impacta en diversas esferas de la vida del paciente y su entorno familiar y social. Se trata de una enfermedad compleja que requiere un abordaje multidisciplinario tanto para el diagnóstico como para el tratamiento, así como en lo relativo al manejo de la toxicidad mediata y tardía del tratamiento sistémico y la radioterapia y también los aspectos psicológicos. Los cuidados paliativos y el manejo del dolor se incorporan cada vez más tempranamente al tratamiento en beneficio de los pacientes. Actualmente se ha incorporado a los genetistas a este abordaje multidisciplinario debido a los avances en genotipificación y terapias dirigidas. La difusión de este consenso contribuye a la actualización y homogeneidad de criterios de manejo del cáncer mamario y el objetivo de este artículo es el presentar la actualización en el manejo multidisciplinario del cáncer de mama.

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Impact de la radiothérapie thoracique sur les structures cardiaques

Cited by 5 publications

References 74 publications

Evaluation of Cardiac Substructures Exposure of DIBH-3DCRT, FB-HT, and FB-3DCRT in Hypofractionated Radiotherapy for Left-Sided Breast Cancer after Breast-Conserving Surgery: An In Silico Planning Study

Evaluation of Cardiac Substructures Exposure of DIBH-3DCRT, FB-HT, and FB-3DCRT in Hypofractionated Radiotherapy for Left-Sided Breast Cancer after Breast-Conserving Surgery: An In Silico Planning Study

Mexican breast cancer consensus. Multidisciplinary care in breast cancer

Consenso mexicano de cáncer mamario. Cuidados multidisciplinarios en cáncer de mama

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