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No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction
The aim of this study was to quantify the variation in doses to organs at risk (ipsilateral lung and heart) and the clinical target volume (CTV) in the presence of breast implants. In this retrospective cohort study, patients were identified through the National Breast Cancer Register. Consecutive b...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907145/ https://www.ncbi.nlm.nih.gov/pubmed/24406085 http://dx.doi.org/10.1186/1748-717X-9-14 |
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author | Liljegren, Annelie Unukovych, Dmytro Gagliardi, Giovanna Bjöhle, Judith Wickman, Marie Johansson, Hemming Sandelin, Kerstin |
author_facet | Liljegren, Annelie Unukovych, Dmytro Gagliardi, Giovanna Bjöhle, Judith Wickman, Marie Johansson, Hemming Sandelin, Kerstin |
author_sort | Liljegren, Annelie |
collection | PubMed |
description | The aim of this study was to quantify the variation in doses to organs at risk (ipsilateral lung and heart) and the clinical target volume (CTV) in the presence of breast implants. In this retrospective cohort study, patients were identified through the National Breast Cancer Register. Consecutive breast cancer patients undergoing mastectomy between 2009 and 2011 and completing a full course of postmastectomy radiotherapy (PMRT) were eligible. All included patients (n = 818) were identified in the ARIA© oncology information system and further stratified for immediate breast reconstruction (IBR+, n = 162) and no immediate breast reconstruction (IBR-, n = 656). Dose statistics for ipsilateral lung, heart and CTV were retrieved from the system. Radiation plans for patients with chest wall (CW) only (n = 242) and CW plus lymph nodes (n = 576) irradiation were studied separately. The outcome variables were dichotomized as follows: lung, V(20Gy) ≤ 30% vs. V(20Gy) > 30%; heart, D(mean) ≤ 5 Gy vs. D(mean) > 5 Gy; CTV, V(95%) ≥ median vs. V(95%) < median. In the univariate and multivariate regression models no correlation between potential confounders (i.e. breast reconstruction, side of PMRT, CW index) and the outcome variables was found. Multivariate analysis of CW plus lymph nodes radiation plans, for example, showed no association of breast reconstruction with dosimetric outcomes in neither lung nor heart- lung V(20Gy) (odds ratio [OR]: 0.6, 95%CI, 0.4 to 1.0, p = 0.07) or heart D(mean) (OR: 1.2, 95%CI, 0.5 to 3.1, p = 0.72), respectively. CTV was statistically significantly larger in the IBR+ group (i.e. included breast implant), but no correlation between the implant type and dosimetric characteristics of the organs at risk was revealed. In the current study, the presence of breast implants during postmastectomy radiotherapy was not associated with increased doses to ipsilateral lung and heart, but CTV definition and its dosimetric characteristics urge further evaluation. |
format | Online Article Text |
id | pubmed-3907145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-39071452014-01-31 No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction Liljegren, Annelie Unukovych, Dmytro Gagliardi, Giovanna Bjöhle, Judith Wickman, Marie Johansson, Hemming Sandelin, Kerstin Radiat Oncol Research The aim of this study was to quantify the variation in doses to organs at risk (ipsilateral lung and heart) and the clinical target volume (CTV) in the presence of breast implants. In this retrospective cohort study, patients were identified through the National Breast Cancer Register. Consecutive breast cancer patients undergoing mastectomy between 2009 and 2011 and completing a full course of postmastectomy radiotherapy (PMRT) were eligible. All included patients (n = 818) were identified in the ARIA© oncology information system and further stratified for immediate breast reconstruction (IBR+, n = 162) and no immediate breast reconstruction (IBR-, n = 656). Dose statistics for ipsilateral lung, heart and CTV were retrieved from the system. Radiation plans for patients with chest wall (CW) only (n = 242) and CW plus lymph nodes (n = 576) irradiation were studied separately. The outcome variables were dichotomized as follows: lung, V(20Gy) ≤ 30% vs. V(20Gy) > 30%; heart, D(mean) ≤ 5 Gy vs. D(mean) > 5 Gy; CTV, V(95%) ≥ median vs. V(95%) < median. In the univariate and multivariate regression models no correlation between potential confounders (i.e. breast reconstruction, side of PMRT, CW index) and the outcome variables was found. Multivariate analysis of CW plus lymph nodes radiation plans, for example, showed no association of breast reconstruction with dosimetric outcomes in neither lung nor heart- lung V(20Gy) (odds ratio [OR]: 0.6, 95%CI, 0.4 to 1.0, p = 0.07) or heart D(mean) (OR: 1.2, 95%CI, 0.5 to 3.1, p = 0.72), respectively. CTV was statistically significantly larger in the IBR+ group (i.e. included breast implant), but no correlation between the implant type and dosimetric characteristics of the organs at risk was revealed. In the current study, the presence of breast implants during postmastectomy radiotherapy was not associated with increased doses to ipsilateral lung and heart, but CTV definition and its dosimetric characteristics urge further evaluation. BioMed Central 2014-01-09 /pmc/articles/PMC3907145/ /pubmed/24406085 http://dx.doi.org/10.1186/1748-717X-9-14 Text en Copyright © 2014 Liljegren et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Liljegren, Annelie Unukovych, Dmytro Gagliardi, Giovanna Bjöhle, Judith Wickman, Marie Johansson, Hemming Sandelin, Kerstin No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
title | No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
title_full | No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
title_fullStr | No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
title_full_unstemmed | No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
title_short | No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
title_sort | no difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907145/ https://www.ncbi.nlm.nih.gov/pubmed/24406085 http://dx.doi.org/10.1186/1748-717X-9-14 |
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