Evidence map›Paper›PMID 40859703›Full record

SynthesisActa oncologica (Stockholm, Sweden)2025

Radiation exposure of breast tissue in lymphoma radiotherapy: a systematic review of breast dose metrics published since 2000.

Hannah Chamberlin, Georgios Ntentas, David J Cutter, Richard Cowan, Sacha Howell, Christina Hague, John Radford, Sue Astley, Eliana Vasquez Osorio, Marianne Aznar

Abstract readSystematic Review
In one paragraph

Synthesis in Acta oncologica (Stockholm, Sweden), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hannah ChamberlinRadiotherapy Related Research Group, Division of Cancer Sciences, University of Manchester, Manchester, UK.ORCID 0000-0003-0541-220X
Georgios NtentasGuy's and St Thomas' NHS Foundation Trust, Medical Physics, London, United Kingdom; University of Oxford, Nuffield Department of Population Health, London, United Kingdom; King's College London, School of Biomedical Engineering & Imaging Sciences, London, United Kingdom.
David J CutterUniversity of Oxford, Nuffield Department of Population Health, London, United Kingdom; Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Richard CowanDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
Sacha HowellDivision of Cancer Sciences, University of Manchester, Manchester, UK.
Christina HagueDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
John RadfordDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK.
Sue AstleyDivision of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Eliana Vasquez OsorioRadiotherapy Related Research Group, Division of Cancer Sciences, University of Manchester, Manchester, UK.
Marianne AznarRadiotherapy Related Research Group, Division of Cancer Sciences, University of Manchester, Manchester, UK. Marianne.aznar@manchester.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeWe present a systematic review of breast dose metrics reported in lymphoma patients receiving radiotherapy and provide reporting recommendations for breast dose in future publications. METHODS AND MATERIALS: Studies reporting breast doses in lymphoma radiotherapy published between January 2000 and May 2023 were included. Frequency of reporting factors likely to affect breast dose were calculated. Doses for the most frequently reported metrics (mean breast dose (MBD) (Gy, percentage of prescription), V5Gy and V10Gy (%)) were calculated across articles and compared for target volume approaches, radiotherapy techniques, and inclusion of the axilla.

resultsThirty-four distinct breast dose metrics were found across 57 articles. MBD was the most commonly reported. Axilla irradiation significantly increased MBD, V5Gy and V10Gy, yet 21 articles reported breast doses for a mixed cohort with respect to axillary irradiation. Forty-eight of 57 articles did not report the breast contouring guidelines used. Among articles reporting MBD for proton or butterfly-volumetric modulated arc therapy (VMAT), there was no significant reduction in breast radiation dose for protons compared to butterfly-VMAT.

interpretationA wide variety of breast dose metrics are reported in the literature, making it challenging to pool breast tissue exposure data in lymphoma radiotherapy. Factors shown in individual studies to affect breast dose should be reported more systematically to enable large scale analysis. Reporting the presence/absence of axillary irradiation is crucial, due to the significant effect on breast dose. We provide reporting recommendations for breast dose metrics to improve research into radiotherapy-induced breast cancer.

Indexed as

BreastLymphomaOrgans at RiskRadiation ExposureAxillaFemaleHumansRadiotherapy DosageRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-Assisted

Identifiers

PMID40859703
PMCPMC12398104

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Registered trials

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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.