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:: Volume 21, Issue 4 (10-2023) ::
Int J Radiat Res 2023, 21(4): 627-632 Back to browse issues page
Dosimetric evaluation of adding left ventricle and left anterior descending coronary artery cardiac substructures to plan optimization in left lung cancer radiotherapy
I.H. Suyusal , A.O. Konuk , U. Diremsizoglu
Kocaeli University Radiation Oncology Department, Kocaeli, Turkey , suyusalih@yahoo.com
Abstract:   (1050 Views)
Background: The impact of doses on the left ventricle (LV) and left anterior descending artery (LAD) in relation to major adverse cardiac events is well documented. Studies performed on breast cancer have shown that LV doses are correlated with cardiac toxicity. Materials and Methods: Thirty-two patients with left lung cancer who received radiotherapy at our center were evaluated retrospectively. The left ventricle (LV) and left anterior descending artery (LAD) were contoured as organs at risk on CT simulation images. Seven fields were used in intensity-modulated radiation therapy (IMRT) plans, while two partial arcs were used to create volumetric modulated arc therapy (VMAT) plans. Conventional plans were compared with LV and LAD sparing plans dosimetrically. Results: When comparing conventional plans to sparing plans, no statistically significant differences were found in target volume parameters and values related to critical structures (p>0.05). However, when evaluating the heart (Dmean and V25) and its substructures (LADmean, V15, V30, and LV V5, V10, V15, V30, V40), the plan with LV and LAD sparing demonstrated significantly better outcomes (p<0.05). Conclusion: Therefore, it is essential to contour the substructures of the heart as organs at risk, particularly including LAD and LV in the optimization algorithm during radiotherapy planning for central lung tumors located near the heart.
Keywords: Left Lung Cancer, intensity-modulated radiotherapy, volumetric modulated arc therapy, left ventricle and left anterior descending artery, heart-protecting radiotherapy.
Full-Text [PDF 689 kb]   (563 Downloads)    
Type of Study: Original Research | Subject: Radiation Biology
References
1. 1. Babalioglu I SC, Gokce A, Hicsonmez S, et al. (2020) Positron emission tomography-computed tomography guided radiotheraphy planning in lung cancer. Int J Radiat Res, 18(1): 91-98.
2. Dess RT, Sun Y, Matuszak MM, et al. (2017) Cardiac events after radiation therapy: Combined analysis of prospective multicenter trials for locally advanced non-small-cell lung cancer. Journal of Clinical Oncology, 35(13): 1395-1402. [DOI:10.1200/JCO.2016.71.6142] [PMID] []
3. Bradley JD, Paulus R, Komaki R, et al. (2015) Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with Stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): A randomised, two-by-two factorial phase 3 study. The Lancet Oncology, 16(2): 187-199. [DOI:10.1016/S1470-2045(14)71207-0]
4. Darby SC, Ewertz M, McGale P, et al. (2013) Risk of ischemic heart disease in women after radiotherapy for breast cancer. New England Journal of Medicine, 368(11): 987-998. [DOI:10.1056/NEJMoa1209825] [PMID]
5. Hahn E, Jiang H, Ng A, et al. (2017) Late cardiac toxicity after mediastinal radiation therapy for Hodgkin lymphoma: Contributions of coronary artery and whole heart dose-volume variables to risk prediction. Int J Radiat Oncol Biol Phys, 98(5): 1116-1123. [DOI:10.1016/j.ijrobp.2017.03.026] [PMID]
6. Tjong MC, Bitterman DS, Brantley K, et al. (2022) Major adverse cardiac event risk prediction model incorporating baseline cardiac disease, hypertension, and logarithmic left anterior descending coronary artery radiation dose in lung cancer (CHyLL). Radiotherapy and Oncology, 169: 105-113. [DOI:10.1016/j.radonc.2022.02.010] [PMID]
7. Lind PA, Pagnanelli R, Marks LB, et al. (2003) Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution. Int J Radiat Oncol Biol Phys, 55(4): 914-920. [DOI:10.1016/S0360-3016(02)04156-1]
8. Hatakenaka M, Yonezawa M, Nonoshita T, et al. (2012). Acute cardiac impairment associated with concurrent chemoradiotherapy for esophageal cancer: Magnetic Resonance Evaluation. Int J Radiat Oncol Biol Phys, 83(1): 67-73. [DOI:10.1016/j.ijrobp.2011.12.018] [PMID]
9. Chen H, Shao Y, Wang H, et al. (2022) Do auto -planning intensity modulated radiotherapy treatment plans for central lung cancer have improved quality over manual plans?. Int J Radiat Res, 20(2): 499 -505. [DOI:10.52547/ijrr.20.2.35]
10. Piroth MD, Baumann R, Budach W, et al. (2018) Heart toxicity from breast cancer radiotherapy. Strahlentherapie Und Onkologie, 195: 1-12. [DOI:10.1007/s00066-018-1378-z] [PMID] []
11. Chun SG, Hu C, Choy H, et al. (2017) Impact of intensity-modulated radiation therapy technique for locally advanced non-small-cell lung cancer: A secondary analysis of the NRG oncology RTOG 0617 Randomized clinical trial. Journal of Clinical Oncology, 35(1): 56-62. [DOI:10.1200/JCO.2016.69.1378] [PMID] []
12. Duane F, Aznar MC, Bartlett F, et al. (2017) A cardiac contouring atlas for radiotherapy. Radiotherapy and Oncology, 122(3): 416-422. [DOI:10.1016/j.radonc.2017.01.008] [PMID] []
13. Prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). (2010). Journal of the ICRU, 10(1): 1-3. [DOI:10.1093/jicru_ndq002]
14. Marks LB, Yorke ED, Jackson A, et al. (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys, 76(3): 10-19. [DOI:10.1016/j.ijrobp.2009.07.1754] [PMID] []
15. Wang X, Palaskas NL, Hobbs BP, et al. (2022). The impact of radiation dose to heart substructures on major coronary events and patient survival after chemoradiation therapy for esophageal cancer. Cancers, 14(5): 1304. [DOI:10.3390/cancers14051304] [PMID] []
16. Abraham A, Sanghera KP, Gheisari F, et al. (2022) Is radiation-induced cardiac toxicity reversible? Prospective evaluation of patients with breast cancer enrolled in a phase 3 randomized controlled trial. Int J Radiat Oncol Biol Phys, 113(1): 125-134. [DOI:10.1016/j.ijrobp.2022.01.020] [PMID]
17. Tanaka S, Kadoya N, Umezawa R, et al. (2021). Evaluation of the dosimetric impact of heart function-based volumetric modulated arc therapy planning in patients with esophageal cancer. Radiological Physics and Technology, 14(3): 279-287. [DOI:10.1007/s12194-021-00623-5] [PMID]
18. Duma MN, Herr A, Borm KJ, et al. (2017) Tangential field radiotherapy for breast cancer-the dose to the heart and heart subvolumes: What structures must be contoured in future clinical trials? Frontiers in Oncology, 7(2017):7. [DOI:10.3389/fonc.2017.00130] [PMID] []
19. Atkins KM, Chaunzwa TL, Lamba N, et al. (2021) Association of left anterior descending coronary artery radiation dose with major adverse cardiac events and mortality in patients with non-small cell lung cancer. JAMA Oncology, 7(2): 206. [DOI:10.1001/jamaoncol.2020.6332] [PMID] []
20. Wennstig A, Garmo H, Isacsson U, et al. (2019). The relationship between radiation doses to coronary arteries and location of coronary stenosis requiring intervention in breast cancer survivors. Radiation Oncology, 14(1):40. [DOI:10.1186/s13014-019-1242-z] [PMID] []
21. Badiyan SN, Robinson CG, Bradley JD (2019) Radiation toxicity in lung cancer patients: The heart of the problem? Int J Radiat Oncol Biol Phys, 104(3): 590-592. [DOI:10.1016/j.ijrobp.2019.03.007] [PMID]
22. Poitevin-Chacón A, Chávez-Nogueda J, Prudencio RR, et al. (2018) Dosimetry of the left anterior descending coronary artery in left breast cancer patients treated with postoperative external radiotherapy. Reports of Practical Oncology & Radiotherapy, 23(2): 91-96. [DOI:10.1016/j.rpor.2018.01.003] [PMID] []
23. Patel S, Mahmood S, Nguyen T, et al. (2018) Comparing whole heart versus coronary artery dosimetry in predicting the risk of cardiac toxicity following breast radiation therapy. Int J Radiat Oncol Biol Phys, 102(3):46. [DOI:10.1016/j.ijrobp.2018.06.091]
24. Ferris MJ, Martin, KS, Switchenko JM, et al. (2019). Sparing cardiac substructures with optimized volumetric modulated arc therapy and intensity modulated proton therapy in thoracic radiation for locally advanced non-small cell lung cancer. Practical Radiation Oncology, 9(5): 473-481. [DOI:10.1016/j.prro.2019.04.013] [PMID] []
25. Zhao H, He M, Cheng G, et al. (2015) A comparative dosimetric study of left sided breast cancer after breast-conserving surgery treated with VMAT and IMRT. Radiation Oncology, 10(1):231. [DOI:10.1186/s13014-015-0531-4] [PMID] []
26. Welsh B, Chao M, Foroudi F (2016). Reducing cardiac doses: A novel multi-leaf collimator modification technique to reduce left anterior descending coronary artery dose in patients with left-sided breast cancer. Journal of Medical Radiation Sciences, 64(2): 114-119. [DOI:10.1002/jmrs.191] [PMID] []
27. Arslan A, Aktas E, Sengul, B, Tekin B (2020) Dosimetric evaluation of left ventricle and left anterior descending artery in left breast radiotherapy. La Radiologia Medica, 126(1): 14-21. [DOI:10.1007/s11547-020-01201-2] [PMID]
28. Morris ED, Aldridge K, Ghanem AI, et al. (2020) Incorporating sensitive cardiac substructure sparing into radiation therapy planning. J Appl Clin Med Phys, 21(11): 195-204. [DOI:10.1002/acm2.13037] [PMID] []
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Suyusal I, Konuk A, Diremsizoglu U. Dosimetric evaluation of adding left ventricle and left anterior descending coronary artery cardiac substructures to plan optimization in left lung cancer radiotherapy. Int J Radiat Res 2023; 21 (4) :627-632
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Volume 21, Issue 4 (10-2023) Back to browse issues page
International Journal of Radiation Research
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