Radiation dose distribution in cardiac valves in left-sided breast cancer radiotherapy

Naimi, Z.; Bennour, E.; Nèji, H.; Hamdoun, A.; Yahyaoui, J.; Hantous, Saoussen; Kochbati, L.

doi:10.1016/s0960-9776(21)00162-4

Cited by 2 publications

(2 citation statements)

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“…To address this issue, it is urgent to clarify whether MHD or dosimetric/volumetric factors of the heart can accurately predict the radiation doses for cardiac valves. Recently, Naimi et al ( 37 ) conducted a study to evaluate whether cardiac valves doses can be safely derived from the MHD or doses to cardiac chambers. MHD and doses to cardiac valves were shown to be significantly correlated, with the Pearson correlation coefficients ranging from 0.51 to 0.63.…”

Section: Discussionmentioning

confidence: 99%

Optimal radiotherapy modality sparing for cardiac valves in left-sided breast cancer

Liu¹,

Tao²,

Wang³

et al. 2023

Ann Transl Med

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Background: The cardiotoxicity caused by radiotherapy is a critical problem in the treatment of patients with breast cancer. The appropriate radiotherapy modality sparing for cardiac valves in left-sided breast cancer has not been well defined. The aim of this study was thus to compare the dosimetric differences in heart and cardiac valves of 3-dimensional conformal radiotherapy (3D-CRT), fixed-field intensity-modulated radiation therapy (IMRT), and volumetric-modulated arc therapy (VMAT) to find the optimal radiotherapy modality sparing for cardiac valves in patients with left breast cancer.Methods: From January 5, 2021, to March 15, 2021, 21 patients with left-sided breast cancer postmastectomy were included in this study, and 3 different plans for adjuvant radiation were created using 3D-CRT, IMRT, and VMAT for each patient. All patients received 50 Gy in 25 fractions. The mean dose (D mean ) of the heart; percentage volume of the heart receiving ≥5 Gy (V 5 ), ≥30 Gy (V 30 ), and ≥40 Gy (V 40 ); and the D mean and the near-maximum dose (D 0.03cc ) of cardiac valves were extracted from dose-volume histograms (DVHs) and compared. The correlations in dosimetric factors between cardiac valves and the whole heart were analyzed.Results: IMRT significantly decreased the values of V 5 , V 30 , V 40 , and D mean in the whole heart compared to 3D-CRT and VMAT (P<0.001). Among the 3 different plans, IMRT had the lowest radiation dose to the D mean and the D 0.03cc of the aortic valve (1.27 Gy/1.75 Gy), pulmonary valve (3.44 Gy/6.89 Gy), tricuspid valve (1.02 Gy/1.14 Gy), and mitral valve (0.93 Gy/1.00 Gy). Pearson correlation analysis found that local parameters (D mean and D 0.03cc ) within valves were strongly correlated to the global parameters (V 5 , V 30 , V 40 , and D mean ) of the heart.Conclusions: This study revealed that IMRT showed the lowest cardiac valves dose compared with 3D-CRT and VMAT in left-sided breast cancer radiotherapy. IMRT might be the optimal modality sparing for cardiac valves in this group of patients. Further studies need to be carried out in order to validate the protective role of IMRT on the cardiac valves.

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Section: Discussionmentioning

confidence: 99%

Optimal radiotherapy modality sparing for cardiac valves in left-sided breast cancer

Liu¹,

Tao²,

Wang³

et al. 2023

Ann Transl Med

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“…One study showed that more than 20 years after radiotherapy, the prevalence of aortic valve regurgitation was 60% [31]. Another study showed the high exposure of the pulmonary valve to radiotherapy for left breast cancer and low‐dose radiotherapy of other heart valves [32]. Transthoracic echocardiography (TTE) is commonly used for the diagnosis and monitoring of radiation‐induced valvular disease [33].…”

Section: Radiation‐induced Heart Diseasementioning

confidence: 99%

Advances in multimodality imaging and the application of new cardiac imaging technologies for radiation‐induced heart disease

Du,

Lan,

Shen

et al. 2024

iRADIOLOGY

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Radiation‐induced heart disease (RIHD) is a heterogeneous, delayed, and potentially fatal adverse reaction to radiation that can damage all structures of the heart, including the pericardium, myocardium, coronary arteries, valves, and conduction system, leading to a series of diseases. Acute and chronic disease processes play a role in the development of RIHD, the onset times of which range from months to decades. However, the clinical manifestations of RIHD are usually insidious, overlap with several other diseases, and lack specificity. Cardiovascular imaging is essential for early diagnosis, follow‐up, and outcome assessment in patients with RIHD. This review first describes the pathogenesis and clinical manifestations of RIHD before providing an overview of the practical approaches and research advances in multimodal cardiovascular imaging in patients with RIHD, including echocardiography, cardiac magnetic resonance (CMR) and nuclear medicine, and cardiac computed tomography (CT). Then, the value of new cardiac imaging assessments for the early diagnosis of RIHD is described, particularly with relation to speckle‐tracking echocardiography, extracellular volume fraction assessment as a quantitative CMR technique, CMR myocardial strain assessment, positron emission tomography‐CT myocardial perfusion imaging, CT‐ECV, and CT strain assessment, amongst others. In addition, the advantages and disadvantages of each screening technique are compared with the aim of better guiding the follow‐up and diagnosis of subclinical RIHD and preventing cardiovascular events.

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Radiation dose distribution in cardiac valves in left-sided breast cancer radiotherapy

Cited by 2 publications

References 0 publications

Optimal radiotherapy modality sparing for cardiac valves in left-sided breast cancer

Optimal radiotherapy modality sparing for cardiac valves in left-sided breast cancer

Advances in multimodality imaging and the application of new cardiac imaging technologies for radiation‐induced heart disease

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