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Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients
Purpose In left-sided breast cancer radiotherapy, tangential intensity modulated radiotherapy combined with breath-hold enables a dose reduction to the heart and left anterior descending (LAD) coronary artery. Aim of this study was to investigate the added value of intensity modulated proton therapy...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196139/ https://www.ncbi.nlm.nih.gov/pubmed/25266130 http://dx.doi.org/10.1007/s10549-014-3149-6 |
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author | Mast, Mirjam E. Vredeveld, Eline J. Credoe, Herman M. van Egmond, Jaap Heijenbrok, Mark W. Hug, Eugen B. Kalk, Patrick van Kempen-Harteveld, Loes M. L. Korevaar, Erik W. van der Laan, Hans Paul Langendijk, Johannes A. Rozema, Hans J. E. Petoukhova, Anna L. Schippers, Jacobus M. Struikmans, Henk Maduro, John H. |
author_facet | Mast, Mirjam E. Vredeveld, Eline J. Credoe, Herman M. van Egmond, Jaap Heijenbrok, Mark W. Hug, Eugen B. Kalk, Patrick van Kempen-Harteveld, Loes M. L. Korevaar, Erik W. van der Laan, Hans Paul Langendijk, Johannes A. Rozema, Hans J. E. Petoukhova, Anna L. Schippers, Jacobus M. Struikmans, Henk Maduro, John H. |
author_sort | Mast, Mirjam E. |
collection | PubMed |
description | Purpose In left-sided breast cancer radiotherapy, tangential intensity modulated radiotherapy combined with breath-hold enables a dose reduction to the heart and left anterior descending (LAD) coronary artery. Aim of this study was to investigate the added value of intensity modulated proton therapy (IMPT) with regard to decreasing the radiation dose to these structures. Methods In this comparative planning study, four treatment plans were generated in 20 patients: an IMPT plan and a tangential IMRT plan, both with breath-hold and free-breathing. At least 97 % of the target volume had to be covered by at least 95 % of the prescribed dose in all cases. Specifically with respect to the heart, the LAD, and the target volumes, we analyzed the maximum doses, the mean doses, and the volumes receiving 5–30 Gy. Results As compared to IMRT, IMPT resulted in significant dose reductions to the heart and LAD-region even without breath-hold. In the majority of the IMPT cases, a reduction to almost zero to the heart and LAD-region was obtained. IMPT treatment plans yielded the lowest dose to the lungs. Conclusions With IMPT the dose to the heart and LAD-region could be significantly decreased compared to tangential IMRT with breath-hold. The clinical relevance should be assessed individually based on the baseline risk of cardiac complications in combination with the dose to organs at risk. However, as IMPT for breast cancer is currently not widely available, IMPT should be reserved for patients remaining at high risk for major coronary events. |
format | Online Article Text |
id | pubmed-4196139 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-41961392014-10-16 Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients Mast, Mirjam E. Vredeveld, Eline J. Credoe, Herman M. van Egmond, Jaap Heijenbrok, Mark W. Hug, Eugen B. Kalk, Patrick van Kempen-Harteveld, Loes M. L. Korevaar, Erik W. van der Laan, Hans Paul Langendijk, Johannes A. Rozema, Hans J. E. Petoukhova, Anna L. Schippers, Jacobus M. Struikmans, Henk Maduro, John H. Breast Cancer Res Treat Preclinical Study Purpose In left-sided breast cancer radiotherapy, tangential intensity modulated radiotherapy combined with breath-hold enables a dose reduction to the heart and left anterior descending (LAD) coronary artery. Aim of this study was to investigate the added value of intensity modulated proton therapy (IMPT) with regard to decreasing the radiation dose to these structures. Methods In this comparative planning study, four treatment plans were generated in 20 patients: an IMPT plan and a tangential IMRT plan, both with breath-hold and free-breathing. At least 97 % of the target volume had to be covered by at least 95 % of the prescribed dose in all cases. Specifically with respect to the heart, the LAD, and the target volumes, we analyzed the maximum doses, the mean doses, and the volumes receiving 5–30 Gy. Results As compared to IMRT, IMPT resulted in significant dose reductions to the heart and LAD-region even without breath-hold. In the majority of the IMPT cases, a reduction to almost zero to the heart and LAD-region was obtained. IMPT treatment plans yielded the lowest dose to the lungs. Conclusions With IMPT the dose to the heart and LAD-region could be significantly decreased compared to tangential IMRT with breath-hold. The clinical relevance should be assessed individually based on the baseline risk of cardiac complications in combination with the dose to organs at risk. However, as IMPT for breast cancer is currently not widely available, IMPT should be reserved for patients remaining at high risk for major coronary events. Springer US 2014-10-01 2014 /pmc/articles/PMC4196139/ /pubmed/25266130 http://dx.doi.org/10.1007/s10549-014-3149-6 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by-nc/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Preclinical Study Mast, Mirjam E. Vredeveld, Eline J. Credoe, Herman M. van Egmond, Jaap Heijenbrok, Mark W. Hug, Eugen B. Kalk, Patrick van Kempen-Harteveld, Loes M. L. Korevaar, Erik W. van der Laan, Hans Paul Langendijk, Johannes A. Rozema, Hans J. E. Petoukhova, Anna L. Schippers, Jacobus M. Struikmans, Henk Maduro, John H. Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
title | Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
title_full | Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
title_fullStr | Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
title_full_unstemmed | Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
title_short | Whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
title_sort | whole breast proton irradiation for maximal reduction of heart dose in breast cancer patients |
topic | Preclinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196139/ https://www.ncbi.nlm.nih.gov/pubmed/25266130 http://dx.doi.org/10.1007/s10549-014-3149-6 |
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