ArticleBreast cancer research and treatment2014
Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients.
Article in Breast cancer research and treatment, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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32 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.
- BNP as a potential biomarker for cardiac damage of breast cancer after radiotherapy: a meta-analysis.Medicine · 2019Pooled it
- Laterality of Breast Radiotherapy and Ischemic Heart Disease by Cardiovascular Risk Burden.JAMA network open · 2026Article
- Toxicity profiles of proton and photon radiotherapy in postoperative breast cancer: a 10-year real-world cohort study.Breast cancer research : BCR · 2026Article
- Cardiac Substructure Dose Reduction and Toxicity Risk Assessment: IMPT Versus IMRT for Breast Cancer.International journal of particle therapy · 2025Article
- Prediction of Radiation Therapy Induced Cardiovascular Toxicity from Pretreatment CT Images in Patients with Thoracic Malignancy via an Optimal Biomarker Approach.Academic radiology · 2025Article
- Evaluation of a non-metallic dual-port expander for intensity modulated proton therapy.Journal of applied clinical medical physics · 2024Article
- Proton therapy for breast cancer: Reducing toxicity.Thoracic cancer · 2024Review
- Impact on the Transcriptome of Proton Beam Irradiation Targeted at Healthy Cardiac Tissue of Mice.Cancers · 2024Article
- Differences in Patterns of Care and Referral Between Proton and Photon Therapy.International journal of particle therapy · 2024Article
- Review
- A retrospective study of adjuvant proton radiotherapy for breast cancer after lumpectomy: a comparison of conventional-dose and hypofractionated dose.Radiation oncology (London, England) · 2023Article
- Breast cancer heterogeneity and its implication in personalized precision therapy.Experimental hematology & oncology · 2023Review
- Particle Therapy for Breast Cancer.Cancers · 2022Review
- Cost-effectiveness of using protons for breast irradiation aiming at minimizing cardiotoxicity: A risk-stratification analysis.Frontiers in medicine · 2022Article
- Proton Therapy for Breast Cancer: A Consensus Statement From the Particle Therapy Cooperative Group Breast Cancer Subcommittee.International journal of radiation oncology, biology, physics · 2021Review
- Future Perspectives of Proton Therapy in Minimizing the Toxicity of Breast Cancer Radiotherapy.Journal of personalized medicine · 2021Review
- Breast Radiotherapy-Related Cardiotoxicity. When, How, Why. Risk Prevention and Control Strategies.Cancers · 2021Review
- Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy.Radiation oncology (London, England) · 2020Article
- Selection of patients with left breast cancer for IMRT with deep inspiration breath-hold technique.Journal of radiation research · 2020Article
- Cardiac Sparing with Personalized Treatment Planning for Early-stage Left Breast Cancer.Cureus · 2020Article
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Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn left-sided breast cancer radiotherapy, tangential intensity modulated radiotherapy combined with breath-hold enables a dose reduction to the heart and left anterior descending (LAD) coronary artery. Aim of this study was to investigate the added value of intensity modulated proton therapy (IMPT) with regard to decreasing the radiation dose to these structures.
methodsIn this comparative planning study, four treatment plans were generated in 20 patients: an IMPT plan and a tangential IMRT plan, both with breath-hold and free-breathing. At least 97 % of the target volume had to be covered by at least 95 % of the prescribed dose in all cases. Specifically with respect to the heart, the LAD, and the target volumes, we analyzed the maximum doses, the mean doses, and the volumes receiving 5-30 Gy.
resultsAs compared to IMRT, IMPT resulted in significant dose reductions to the heart and LAD-region even without breath-hold. In the majority of the IMPT cases, a reduction to almost zero to the heart and LAD-region was obtained. IMPT treatment plans yielded the lowest dose to the lungs.
conclusionsWith IMPT the dose to the heart and LAD-region could be significantly decreased compared to tangential IMRT with breath-hold. The clinical relevance should be assessed individually based on the baseline risk of cardiac complications in combination with the dose to organs at risk. However, as IMPT for breast cancer is currently not widely available, IMPT should be reserved for patients remaining at high risk for major coronary events.
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