Dosimetric parameters associated with radiation-induced esophagitis in breast cancer patients undergoing regional nodal irradiation

Yaney, Alexander; Ayan, A.S.; Pan, Xueliang; Jhawar, Sachin R.; Healy, Erin; Beyer, Sasha; Lindsey, Kylee; Kuhn, Karla; Tedrick, Kayla; White, Julia; Bazan, Jose G.

doi:10.1016/j.radonc.2020.10.042

Cited by 22 publications

(19 citation statements)

References 24 publications

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“…However, our findings with respect to VMAT versus 3DCRT contradicts previous studies. In one study where the esophagus was not contoured (31) and another study where the dose-constraint of the esophagus (Dmax less than 40 Gy) was higher than our method (D0.03cc less than 12 Gy) (30), the esophageal dose was higher in patients treated with IMRT compared to patients treated with 3DCRT. A study by Yaney et al also showed that these dosimetric differences translated into an increased rate of grade 2 esophagitis in patients with IMRT.…”

Section: Other Oarsmentioning

confidence: 67%

Dosimetric Comparison of Radiation Techniques for Comprehensive Regional Nodal Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study

Chang

Moon

et al. 2021

Front. Oncol.

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PurposeHow modern cardiac sparing techniques and beam delivery systems using advanced x-ray and proton beam therapy (PBT) can reduce incidental radiation exposure doses to cardiac and pulmonary organs individually or in any combination is poorly investigated.MethodsAmong 15 patients with left-sided breast cancer, partial wide tangential 3D-conformal radiotherapy (3DCRT) delivered in conventional fractionation (CF) or hypofractionated (HF) schedules; PBT delivered in a CF schedule; and volumetric modulated arc therapy (VMAT) delivered in an HF schedule, each under continuous positive airway pressure (CPAP) and free-breathing (FB) conditions, were examined. Target volume coverage and doses to organs-at-risk (OARs) were calculated for each technique. Outcomes were compared with one-way analysis of variance and the Bonferroni test, with p-values <0.05 considered significant.ResultsTarget volume coverage was within acceptable levels in all interventions, except for the internal mammary lymph node D95 (99% in PBT, 90% in VMAT-CPAP, 84% in VMAT-FB, and 74% in 3DCRT). The mean heart dose (MHD) was the lowest in PBT (<1 Gy) and VMAT-CPAP (2.2 Gy) and the highest in 3DCRT with CF/FB (7.8 Gy), respectively. The mean lung dose (MLD) was the highest in 3DCRT-CF-FB (20 Gy) and the lowest in both VMAT-HF-CPAP and PBT (approximately 5–6 Gy). VMAT-HF-CPAP and PBT delivered a comparable maximum dose to the left ascending artery (7.2 and 6.13 Gy, respectively).ConclusionsBoth proton and VMAT in combination with CPAP can minimize the radiation exposure to heart and lung with optimal target coverage in regional RT for left-sided breast cancer. The clinical relevance of these differences is yet to be elucidated. Continued efforts are needed to minimize radiation exposures during RT treatment to maximize its therapeutic index.

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Section: Other Oarsmentioning

confidence: 67%

Dosimetric Comparison of Radiation Techniques for Comprehensive Regional Nodal Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study

Chang

Moon

et al. 2021

Front. Oncol.

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“…The average mean oesophagus dose in these 311 patients was 7.3 Gy but the standard deviation was 4.8 Gy. [22]. Hence this review cannot be used to estimate doses for individual patients.…”

Section: Discussionmentioning

confidence: 99%

Exposure of the oesophagus in breast cancer radiotherapy: A systematic review of oesophagus doses published 2010–2020

Duane

Kerr

Wang

et al. 2021

Radiotherapy and Oncology

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“…Therefore, the cranial border of level 4 in ESTRO guidelines is caudal to that recommended by the RTOG for elective nodal irradiation. This will allow for a reduction in dose to the thyroid gland, internal carotid, and other head & neck OARs [25]. Furthermore, as reported by Chang et al, all level 4 failures were located <6 mm cranial to the subclavian artery [11,26], ESTRO's guideline does recommend extending the cranial border according to nodal tumour load in patients with nodal disease at level 2-3 to cover potential areas that are at high risk for nodal recurrence.…”

Section: Delineation Of Nodal Volumesmentioning

confidence: 96%

Tricks and tips for target volume definition and delineation in breast cancer: Lessons learned from ESTRO breast courses

Kaidar‐Person¹,

Offersen²,

Boersma³

et al. 2021

Radiotherapy and Oncology

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Dosimetric parameters associated with radiation-induced esophagitis in breast cancer patients undergoing regional nodal irradiation

Cited by 22 publications

References 24 publications

Dosimetric Comparison of Radiation Techniques for Comprehensive Regional Nodal Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study

Dosimetric Comparison of Radiation Techniques for Comprehensive Regional Nodal Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study

Exposure of the oesophagus in breast cancer radiotherapy: A systematic review of oesophagus doses published 2010–2020

Tricks and tips for target volume definition and delineation in breast cancer: Lessons learned from ESTRO breast courses

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