Evidence map›Paper›PMID 34992860›Full record

ArticleReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology2021

Lateral wedge with medial only cardiac shielding (LEMONADE) technique in left chest wall adjuvant radiotherapy.

Reduan Abdullah, Gokula Kumar Appalanaido, Syadwa Abdul Shukor, Hafiz M Zin, Mohd Zahri Abd Aziz, Norhafizah Ishak

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Article in Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Reduan AbdullahMedical Radiation Programme, School of Health Sciences, Universiti Sains Malaysia, Penang, Malaysia.
Gokula Kumar AppalanaidoAdvanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.
Syadwa Abdul ShukorDepartment of Radiotherapy and Oncology, Sarawak General Hospital, Sarawak, Malaysia.
Hafiz M ZinAdvanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.
Mohd Zahri Abd AzizAdvanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.
Norhafizah IshakAdvanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis dosimetric study compared lateral wedge with medial only cardiac shielding (LEMONADE) technique, for left chest wall (LCW) irradiation against three other commonly used techniques. MATERIALS AND

methodsDosimetric parameters of 22 consecutive LBC patients treated using the P1 (LEMONADE technique) were compared with 3 other virtually reconstructed plans : no cardiac shielding with paired wedges; P2 (paired wedges and medial only Y-direction shielding) and P3 (paired wedges and bilateral Y-direction shielding).

resultsP1 showed better target volume (TV) coverage with the mean 90% isodose coverage of 85.59% ± 5.44 compared to 78.90% ± 8.59 and 74.22% ± 9.50 for P2 and P3, respectively. Compared to no cardiac shielding, for a 4.65% drop in TV coverage the V26Gy of heart dropped from 6.68% to a negligible 0.85% for P1. TV receiving < 30Gy is also significantly lesser for P1 compared to P2 and P3 (5.42% vs 10.64% and 15.8%), whilst there is a small difference of 2.75% between no cardiac shielding and P1.

conclusionWith the improvement in BC survival rate, cardiac toxicity associated with adjuvant irradiation for LBC is a major concern. P1 (LEMONADE) technique has a good compromise between cardiac sparing and target coverage and should suffice for most LCW irradiations. Furthermore, the LEMONADE technique is a simple, reproducible and involves fast planning for cardiac sparing, which is ideal for under-resourced departments with heavy workload.

Indexed as

cardiac shieldingcardiotoxicityleft breast carcinomaleft chest wall radiotherapymultileaf collimators

Identifiers

PMID34992860
PMCPMC8726450

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