ArticleCureus2022
Dosimetric Comparison of the Heart and Left Anterior Descending Artery in Patients With Left Breast Cancer Treated With Three-Dimensional Conformal and Intensity-Modulated Radiotherapy.
Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 12 citations in OpenAlex.
- Cardiac substructure dose distributions in node-positive and node-negative breast cancer patients undergoing 3D-CRT: comparing the predictive accuracy of mean heart dose and mean left ventricular dose.Radiation oncology (London, England) · 2025Article
- Strategies to Reduce Left Anterior Descending Artery and Left Ventricle Organ Doses in Radiotherapy Planning for Left-Sided Breast Cancer.Reviews in cardiovascular medicine · 2025Article
- Correlations between patient-specific parameters and dosimetric indices for personalized breast cancer radiotherapy.Scientific reports · 2024Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
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Abstract
Background Adjuvant radiotherapy plays an important role in the management of breast cancer, along with surgery and chemotherapy. However, postoperative radiotherapy poses an increased risk of radiation-induced heart diseases in patients with left-sided breast cancer due to damage of the coronary arteries, which can cause myocardial fibrosis and coronary artery disease; however, there is a lack of sufficient evidence for it. Hence, the present study aimed to assess the dosimetric parameters of the heart and left anterior descending (LAD) coronary artery in patients with left breast cancer treated with three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT). Methodology This study included 20 patients with left-sided breast cancer treated between January and July 2019. Patients were equally divided into two groups as follows: group I included those treated with 3DCRT and group II included those treated with IMRT. Radiotherapy was administered to the chest wall and regional lymph nodes. The dose administered for the planning target volume was 50 Gy in 25 daily fractions over five weeks with 6 MV photons. Dosimetric parameters of planning tumor volume (PTV; V95%, V90%, Dmax, Dmin, Dmean, V53.5 Gy, conformity index, and homogeneity index) along with the heart (V5%, V30%, and Dmean) and LAD artery (mean and V25%) were evaluated. Dose-volume histograms were generated and compared. The LAD artery was contoured virtually retrospectively during the study to determine the dosimetric parameters; the dose to the LAD artery was not considered during planning. Results Dosimetric parameters of the PTV were similar for 3DCRT and IMRT; D95 (38.53 vs. 41.61 Gy), D90 (43.67 vs. 44.77 Gy), Dmean (48.3 vs. 48.72 Gy), conformity index (1.10 vs. 1.06), and homogeneity index (0.50 and 0.28) did not show a significant difference. The Dmean for the LAD artery was significantly higher than that for the heart on 3DCRT (23.66 Gy vs. 8.46 Gy; p < 0.0000) and IMRT (31.53 vs. 17.7 Gy; p < 0.0000). The V25 for the LAD artery was significantly higher than that for the heart on 3DCRT (40.27 vs. 14.13 Gy; p < 0.0024) and IMRT (66.21 vs. 27.74 Gy; p < 0.0002). Conclusions Radiation doses to the LAD artery and heart must be evaluated prior to radiotherapy in patients with left breast cancer. Long-term follow-up is needed to evaluate cardiac complications and their association with dosimetric parameters.
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