ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2018
Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease : Effects of modern radiotherapy techniques.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The use of Hybrid Techniques in Whole-Breast Radiotherapy: A Systematic Review.Technology in cancer research & treatmentPooled it
- Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Trial
- Adjuvant hypofractionated radiotherapy with simultaneous integrated boost after breast-conserving surgery: results of a prospective trial.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Trial
- Annual mammographic screening to reduce breast cancer mortality in women from age 40 years: long-term follow-up of the UK Age RCT.Health technology assessment (Winchester, England) · 2020Trial
- Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks.Radiation oncology (London, England) · 2020Trial
- Objective-function-guided automated VMAT planning reduces OAR dose, low-dose exposure, and inter-planner variability in breast radiotherapy.Scientific reports · 2026Article
- Impact of variation in voluntary moderate deep inspiration breath hold on the 3D dose distribution in breast cancer radiotherapy.Technical innovations & patient support in radiation oncology · 2026Article
- Article
- Deep inspiration breath-hold for breast cancer radiotherapy: a modelling study of targeted versus non-targeted strategy for clinical and operational optimisation.The Lancet regional health. Europe · 2026Article
- Cardiopulmonary Substructure Doses are Not Correlated With Cardiorespiratory Fitness Among Breast Cancer Survivors Treated With Contemporary Radiation Therapy.Advances in radiation oncology · 2024Article
- Surface-based deep inspiration breath-hold radiotherapy in left-sided breast cancer: final results from the SAVE-HEART study.ESMO open · 2024Article
- Organ-sparing techniques and dose-volume constrains used in breast cancer radiation therapy - Results from European and Latin American surveys.Clinical and translational radiation oncology · 2024Article
- Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Ultra-Hypofractionated Whole Breast Radiotherapy with Automated Hybrid-VMAT Technique: A Pilot Study on Safety, Skin Toxicity and Aesthetic Outcomes.Breast cancer (Dove Medical Press) · 2024Article
- Article
- Application of tangent-arc technology for deep inspiration breath-hold radiotherapy in left-sided breast cancer.Frontiers in oncology · 2023Article
- A study of skin marker alignment using different diamond-shaped light fields for prone breast external-beam radiation therapy.Journal of applied clinical medical physics · 2022Article
- Article
- Deep inspiration breath-hold for patients with left-sided breast cancer - A one-fits-all approach? A prospective analysis of patient selection using dosimetrical and practical aspects.The British journal of radiology · 2022Article
- Dosimetric and radiobiological comparison of simultaneous integrated boost radiotherapy for early stage right side breast cancer between three techniques: IMRT, hybrid IMRT and hybrid VMAT.Radiation oncology (London, England) · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeModern breast cancer radiotherapy techniques, such as respiratory-gated radiotherapy in deep-inspiration breath-hold (DIBH) or volumetric-modulated arc radiotherapy (VMAT) have been shown to reduce the high dose exposure of the heart in left-sided breast cancer. The aim of the present study was to comparatively estimate the excess relative and absolute risks of radiation-induced secondary lung cancer and ischemic heart disease for different modern radiotherapy techniques.
methodsFour different treatment plans were generated for ten computed tomography data sets of patients with left-sided breast cancer, using either three-dimensional conformal radiotherapy (3D-CRT) or VMAT, in free-breathing (FB) or DIBH. Dose-volume histograms were used for organ equivalent dose (OED) calculations using linear, linear-exponential, and plateau models for the lung. A linear model was applied to estimate the long-term risk of ischemic heart disease as motivated by epidemiologic data. Excess relative risk (ERR) and 10-year excess absolute risk (EAR) for radiation-induced secondary lung cancer and ischemic heart disease were estimated for different representative baseline risks.
resultsThe DIBH maneuver resulted in a significant reduction of the ERR and estimated 10-year excess absolute risk for major coronary events compared to FB in 3D-CRT plans (p = 0.04). In VMAT plans, the mean predicted risk reduction through DIBH was less pronounced and not statistically significant (p = 0.44). The risk of radiation-induced secondary lung cancer was mainly influenced by the radiotherapy technique, with no beneficial effect through DIBH. VMAT plans correlated with an increase in 10-year EAR for radiation-induced lung cancer as compared to 3D-CRT plans (DIBH p = 0.007; FB p = 0.005, respectively). However, the EARs were affected more strongly by nonradiation-associated risk factors, such as smoking, as compared to the choice of treatment technique.
conclusionThe results indicate that 3D-CRT plans in DIBH pose the lowest risk for both major coronary events and secondary lung cancer.
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