Preventing Cardiotoxicity in Personalized Breast Irradiation
Background: This study aims to assess the benefit of a deep inspiration breath hold (DIBH) over the standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with the LAD dose. Methods: Patients with left-sided breast cancer undergo...
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| Veröffentlicht in: | Cancers 2023-11, Vol.15 (21), p.5153 |
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| creator | Ippolito, Edy Greco, Carlo Marrocco, Maristella Rinaldi, Carla Germana Fiore, Michele Trodella, Luca Eolo D’Angelillo, Rolando Maria Ramella, Sara |
| description | Background: This study aims to assess the benefit of a deep inspiration breath hold (DIBH) over the standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with the LAD dose. Methods: Patients with left-sided breast cancer undergoing whole breast radiotherapy with DIBH were analyzed. All patients included in the analysis had plans in DIBH and free-breathing (FB). Receiving operating characteristics (ROC analysis) were used to identify the cut-off point of parameters to predict the LAD maximum dose > 10 Gy and LAD mean dose > 4 Gy, and the areas under the curve (AUCs) were computed. Post-test probability has been performed to evaluate the effect of parameters’ combination. Results: One hundred ninety-seven patients were analyzed. The LAD dose was significantly reduced in DIBH plans with the maximum and mean dose reduced by 31.7% (mean value 3.5 Gy vs. 4.8 Gy, p ≤ 0.001) and 28.1% (mean value 8.2 Gy vs. 12.8 Gy, p ≤ 0.001) in DIBH plans compared to FB plans. The strongest predictor of the LAD dose (maximum > 10 Gy and mean > 4 Gy) was the minimum distance of LAD from tangent open fields. Other parameters were lung volume and heart volume (LAD Dmax > 10 Gy) and lung volume, heart volume, and breast separation (LAD Dmean > 4 Gy). Conclusion: The dosimetric advantage of DIBH is clear in all patients and DIBH should always be preferred. |
| doi_str_mv | 10.3390/cancers15215153 |
| format | Article |
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Methods: Patients with left-sided breast cancer undergoing whole breast radiotherapy with DIBH were analyzed. All patients included in the analysis had plans in DIBH and free-breathing (FB). Receiving operating characteristics (ROC analysis) were used to identify the cut-off point of parameters to predict the LAD maximum dose > 10 Gy and LAD mean dose > 4 Gy, and the areas under the curve (AUCs) were computed. Post-test probability has been performed to evaluate the effect of parameters’ combination. Results: One hundred ninety-seven patients were analyzed. The LAD dose was significantly reduced in DIBH plans with the maximum and mean dose reduced by 31.7% (mean value 3.5 Gy vs. 4.8 Gy, p ≤ 0.001) and 28.1% (mean value 8.2 Gy vs. 12.8 Gy, p ≤ 0.001) in DIBH plans compared to FB plans. The strongest predictor of the LAD dose (maximum > 10 Gy and mean > 4 Gy) was the minimum distance of LAD from tangent open fields. Other parameters were lung volume and heart volume (LAD Dmax > 10 Gy) and lung volume, heart volume, and breast separation (LAD Dmean > 4 Gy). Conclusion: The dosimetric advantage of DIBH is clear in all patients and DIBH should always be preferred.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15215153</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Adjuvant treatment ; Breast cancer ; Cancer ; Cancer therapies ; Cardiotoxicity ; Cardiovascular disease ; Coronary vessels ; Dosimetry ; Ethics ; Heart ; Medical imaging ; Mortality ; Patients ; Planning ; Radiation therapy ; Radiotherapy ; Womens health</subject><ispartof>Cancers, 2023-11, Vol.15 (21), p.5153</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c364t-45cacffaab2bda1fe6ea591685af5d4a4460372683ed2ce2d4d4443abd134143</cites><orcidid>0000-0003-1889-4578 ; 0000-0002-5782-7717</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>Ippolito, Edy</creatorcontrib><creatorcontrib>Greco, Carlo</creatorcontrib><creatorcontrib>Marrocco, Maristella</creatorcontrib><creatorcontrib>Rinaldi, Carla Germana</creatorcontrib><creatorcontrib>Fiore, Michele</creatorcontrib><creatorcontrib>Trodella, Luca Eolo</creatorcontrib><creatorcontrib>D’Angelillo, Rolando Maria</creatorcontrib><creatorcontrib>Ramella, Sara</creatorcontrib><title>Preventing Cardiotoxicity in Personalized Breast Irradiation</title><title>Cancers</title><description>Background: This study aims to assess the benefit of a deep inspiration breath hold (DIBH) over the standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with the LAD dose. Methods: Patients with left-sided breast cancer undergoing whole breast radiotherapy with DIBH were analyzed. All patients included in the analysis had plans in DIBH and free-breathing (FB). Receiving operating characteristics (ROC analysis) were used to identify the cut-off point of parameters to predict the LAD maximum dose > 10 Gy and LAD mean dose > 4 Gy, and the areas under the curve (AUCs) were computed. Post-test probability has been performed to evaluate the effect of parameters’ combination. Results: One hundred ninety-seven patients were analyzed. The LAD dose was significantly reduced in DIBH plans with the maximum and mean dose reduced by 31.7% (mean value 3.5 Gy vs. 4.8 Gy, p ≤ 0.001) and 28.1% (mean value 8.2 Gy vs. 12.8 Gy, p ≤ 0.001) in DIBH plans compared to FB plans. The strongest predictor of the LAD dose (maximum > 10 Gy and mean > 4 Gy) was the minimum distance of LAD from tangent open fields. Other parameters were lung volume and heart volume (LAD Dmax > 10 Gy) and lung volume, heart volume, and breast separation (LAD Dmean > 4 Gy). Conclusion: The dosimetric advantage of DIBH is clear in all patients and DIBH should always be preferred.</description><subject>Adjuvant treatment</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Cardiotoxicity</subject><subject>Cardiovascular disease</subject><subject>Coronary vessels</subject><subject>Dosimetry</subject><subject>Ethics</subject><subject>Heart</subject><subject>Medical imaging</subject><subject>Mortality</subject><subject>Patients</subject><subject>Planning</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Womens health</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkUtLA0EMxxdRsNSevS548bLtzmsf4KUWH4WCPfS-pDPZMmU7U2emYv30Tq2gFpNDQvjlH5IkyTXJh4zV-UiCkeg8EZQIIthZ0qN5SbOiqPn5r_wyGXi_zqMxRsqi7CV3c4dvaII2q3QCTmkb7LuWOuxTbdJ51LQGOv2BKr13CD6kU-dAaQjamqvkooXO4-A79pPF48Ni8pzNXp6mk_Esk6zgIeNCgmxbgCVdKiAtFgiiJkUloBWKA-dFzkpaVAwVlUgVV5xzBktFGCec9ZPbo-zW2dcd-tBstJfYdWDQ7nxDq6qORssDenOCru3OxQ2-qCoXIg76oVbQYaNNa4MDeRBtxmVJRbwNrSI1_IeKrnCjpTXY6lj_0zA6NkhnvXfYNlunN-D2Dcmbw5uakzexT8wUhSg</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Ippolito, Edy</creator><creator>Greco, Carlo</creator><creator>Marrocco, Maristella</creator><creator>Rinaldi, Carla Germana</creator><creator>Fiore, Michele</creator><creator>Trodella, Luca Eolo</creator><creator>D’Angelillo, Rolando Maria</creator><creator>Ramella, Sara</creator><general>MDPI AG</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1889-4578</orcidid><orcidid>https://orcid.org/0000-0002-5782-7717</orcidid></search><sort><creationdate>20231101</creationdate><title>Preventing Cardiotoxicity in Personalized Breast Irradiation</title><author>Ippolito, Edy ; Greco, Carlo ; Marrocco, Maristella ; Rinaldi, Carla Germana ; Fiore, Michele ; Trodella, Luca Eolo ; D’Angelillo, Rolando Maria ; Ramella, Sara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c364t-45cacffaab2bda1fe6ea591685af5d4a4460372683ed2ce2d4d4443abd134143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adjuvant treatment</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Cardiotoxicity</topic><topic>Cardiovascular disease</topic><topic>Coronary vessels</topic><topic>Dosimetry</topic><topic>Ethics</topic><topic>Heart</topic><topic>Medical imaging</topic><topic>Mortality</topic><topic>Patients</topic><topic>Planning</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ippolito, Edy</creatorcontrib><creatorcontrib>Greco, Carlo</creatorcontrib><creatorcontrib>Marrocco, Maristella</creatorcontrib><creatorcontrib>Rinaldi, Carla Germana</creatorcontrib><creatorcontrib>Fiore, Michele</creatorcontrib><creatorcontrib>Trodella, Luca Eolo</creatorcontrib><creatorcontrib>D’Angelillo, Rolando Maria</creatorcontrib><creatorcontrib>Ramella, Sara</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>ProQuest Research Library</collection><collection>ProQuest Biological Science Journals</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ippolito, Edy</au><au>Greco, Carlo</au><au>Marrocco, Maristella</au><au>Rinaldi, Carla Germana</au><au>Fiore, Michele</au><au>Trodella, Luca Eolo</au><au>D’Angelillo, Rolando Maria</au><au>Ramella, Sara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preventing Cardiotoxicity in Personalized Breast Irradiation</atitle><jtitle>Cancers</jtitle><date>2023-11-01</date><risdate>2023</risdate><volume>15</volume><issue>21</issue><spage>5153</spage><pages>5153-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Background: This study aims to assess the benefit of a deep inspiration breath hold (DIBH) over the standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with the LAD dose. Methods: Patients with left-sided breast cancer undergoing whole breast radiotherapy with DIBH were analyzed. All patients included in the analysis had plans in DIBH and free-breathing (FB). Receiving operating characteristics (ROC analysis) were used to identify the cut-off point of parameters to predict the LAD maximum dose > 10 Gy and LAD mean dose > 4 Gy, and the areas under the curve (AUCs) were computed. Post-test probability has been performed to evaluate the effect of parameters’ combination. Results: One hundred ninety-seven patients were analyzed. The LAD dose was significantly reduced in DIBH plans with the maximum and mean dose reduced by 31.7% (mean value 3.5 Gy vs. 4.8 Gy, p ≤ 0.001) and 28.1% (mean value 8.2 Gy vs. 12.8 Gy, p ≤ 0.001) in DIBH plans compared to FB plans. The strongest predictor of the LAD dose (maximum > 10 Gy and mean > 4 Gy) was the minimum distance of LAD from tangent open fields. Other parameters were lung volume and heart volume (LAD Dmax > 10 Gy) and lung volume, heart volume, and breast separation (LAD Dmean > 4 Gy). Conclusion: The dosimetric advantage of DIBH is clear in all patients and DIBH should always be preferred.</abstract><cop>Basel</cop><pub>MDPI AG</pub><doi>10.3390/cancers15215153</doi><orcidid>https://orcid.org/0000-0003-1889-4578</orcidid><orcidid>https://orcid.org/0000-0002-5782-7717</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adjuvant treatment Breast cancer Cancer Cancer therapies Cardiotoxicity Cardiovascular disease Coronary vessels Dosimetry Ethics Heart Medical imaging Mortality Patients Planning Radiation therapy Radiotherapy Womens health |
| title | Preventing Cardiotoxicity in Personalized Breast Irradiation |
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