ArticleRadiation oncology (London, England)2019
Is mean heart dose a relevant surrogate parameter of left ventricle and coronary arteries exposure during breast cancer radiotherapy: a dosimetric evaluation based on individually-determined radiation dose (BACCARAT study).
Article in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02605512 (Early Detection and Prediction of Cardiotoxicity in Radiotherapy-treated Breast Cancer Patients), which is not on this map. Cited by 95 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Detection and Prediction of Cardiotoxicity in Radiotherapy-treated Breast Cancer Patients
Who cites it
95 citing papers in PubMed, 172 citations in OpenAlex.
- Evaluation of AI-derived LAD artery dose metrics for survival stratification in stage III NSCLC: A secondary analysis of RTOG 0617 trial.Medical physics · 2026Trial
- A randomized trial of early cardiotoxicity in breast cancer patients receiving postoperative IMRT with or without serial cardiac dose constraints.International journal of cancer · 2025Trial
- Interpretable Machine Learning for Choosing Radiation Dose-volume Constraints on Cardio-pulmonary Substructures Associated with Overall Survival in NRG Oncology RTOG 0617.International journal of radiation oncology, biology, physics · 2023Trial
- Ultra-Hypofractionated vs. Moderate Fractionated Whole Breast Three Dimensional Conformal Radiotherapy during the COVID-19 Pandemic.Medicina (Kaunas, Lithuania) · 2022Trial
- A clinical trial to compare a 3D-printed bolus with a conventional bolus with the aim of reducing cardiopulmonary exposure in postmastectomy patients with volumetric modulated arc therapy.Cancer medicine · 2022Trial
- Review
- Feasibility and trade-offs of incorporating cardiac substructure dose constraints in left-sided breast volumetric modulated arc therapy planning.Radiation oncology journal · 2026Article
- Longitudinal changes in NT-proBNP after breast cancer radiotherapy: clinical determinants of its trajectory and association with cardiac dysfunction (BACCARAT study).Clinical and translational radiation oncology · 2026Article
- Serum Pro-N-Cadherin Correlates With Cardiac Injury in the Radiation Late Effects Cohort of Nonhuman Primates.JACC. Advances · 2026Article
- Optimizing Radiotherapy for Left Breast Cancer: A Dosimetric Evaluation of Hypofractionated vs. Conventional VMAT with DIBH.Asian Pacific journal of cancer prevention : APJCP · 2026Article
- Deducing cardiorespiratory motion of cardiac substructures using a novel 5D-MRI workflow for radiotherapy.Physics in medicine and biology · 2026Article
- Dosimetric advantages and clinical feasibility of a novel lateral decubitus position for left breast cancer patients undergoing PORT.Radiation oncology (London, England) · 2026Article
- Cardiotoxicity of Chemoradiotherapy in Patients With Esophageal Cancer: A Systematic Review.Cureus · 2026Review
- The impact of positioning errors on the dose distribution of hypofractionated radiotherapy for left-sided radical breast cancer.Frontiers in oncology · 2026Article
- Development of a model to guide the decision for radiotherapy in deep-inspiration breath-hold in patients with left-sided breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- The evolution of cardiac changes after breast cancer adjuvant radiotherapy - A six-year follow-up study.Clinical and translational radiation oncology · 2026Article
- Redefining cardiac risk in breast radiotherapy: a substructure-based dosimetric and biomarker correlation study.Cardio-oncology (London, England) · 2025Article
- Association between cardiac radiation dose and coronary artery calcification progression in breast cancer patients after radiotherapy: the modifying role of concomitant systemic inflammation (BACCARAT study).Cardio-oncology (London, England) · 2025Article
- Dosimetric Performance of Orthogonal Dual-Layer Multi-Leaf Collimator System on Locally Advanced Lung Cancer: Cardiac Substructures Sparing Plans.Advances in radiation oncology · 2025Article
- Postmastectomy Radiation Therapy: An ASTRO/ASCO/SSO Clinical Practice Guideline.Annals of surgical oncology · 2025Article
35 more citing papers are in PubMed but not listed here.
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Authors and funding
18 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIntra-individual heterogeneity of cardiac exposure is an issue in breast cancer (BC) radiotherapy that was poorly considered in previous cardiotoxicity studies mainly based on mean heart dose (MHD). This dosimetric study analyzes the distribution of individually-determined radiation doses to the heart and its substructures including coronary arteries and evaluate whether MHD is a relevant surrogate parameter of dose for these substructures.
methodsData were collected from the BACCARAT prospective study that included left or right unilateral BC patients treated with 3D-Conformal Radiotherapy (RT) between 2015 and 2017 and followed-up for 2 years with repeated cardiac imaging examinations. A coronary computed tomography angiography (CCTA) was performed before RT for all patients. Registration of the planning CT and CCTA images allowed delineation of the coronary arteries on the planning CT images. Using the 3D dose matrix generated during treatment planning and the added coronary contours, dose distributions were generated for whole heart and the following substructures: left ventricle (LV), left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA). A descriptive analysis of the physical doses in Gray (Gy) was performed, Dmean was the volume-weighted mean dose.
resultsDose distributions were generated for 89 left-sided BC patients (MHD = 2.9 ± 1.5 Gy, Dmean_LAD = 15.7 ± 3.1 Gy) and 15 right-sided BC patients (MHD = 0.5 ± 0.1 Gy; Dmean_RCA = 1.2 ± 0.4 Gy). For left-sided BC patients, the ratio Dmean_LAD/MHD was around 5. Pearson correlation coefficients between MHD and Dmean for delineated substructures were all statistically significant. However, for all substructures, the coefficient of determination R
conclusionOur study illustrates that MHD is not enough to predict with confidence individual patient dose to the LV and coronary arteries, in particular the LAD. For precise radiotherapy-induced cardiotoxicity studies it would be necessary to consider the distribution of doses within these cardiac substructures rather than just the MHD.
trial registrationClinicalTrials.gov: NCT02605512 , Registered 6 November 2015 - Retrospectively registered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.