Cardiac radiation exposure associated with breast cancer radiotherapy: Dose distribution to the heart substructures and coronary arteries (BACCARAT study)
| Autor: | M.O. Bernier, S. Derreumaux, Dominique Laurier, Gaëlle Jimenez, Sophie Jacob, Jean Ferrières, V. Walker, E. Bruguière, Christian Chevelle, Olivier Lairez, David Broggio, Olivier Fondard, J. Camilleri, M. Lapeyre |
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| Přispěvatelé: | PSE-SANTE/SESANE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SDOS/LEDI, PSE-SANTE/SER/UEM, Radiothérapie (Oncorad), Clinique Pasteur, RADIOLOGIE, Clinique Pasteur [Toulouse], Cardiologie générale et interventionnelle, CARDIOLOGIE, CHU RANGUEIL, PSE-SANTE/SESANE, RADIOTHÉRAPIE (ONCORAD), Department of Cardiology B and Epidemiology, Toulouse University Hospital |
| Rok vydání: | 2019 |
| Předmět: |
business.industry
medicine.medical_treatment 030204 cardiovascular system & hematology medicine.disease 3. Good health [STAT]Statistics [stat] Radiation therapy Coronary arteries 03 medical and health sciences 0302 clinical medicine Breast cancer medicine.anatomical_structure Right coronary artery medicine.artery Medicine 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Radiation treatment planning Nuclear medicine Prospective cohort study Cardiac imaging Artery |
| Zdroj: | 29es Journées Européennes de la Société Française de Cardiologie / 29th European Days of the French Society of Cardiology, JESFC 29es Journées Européennes de la Société Française de Cardiologie / 29th European Days of the French Society of Cardiology, JESFC, 2019, PARIS, France |
| ISSN: | 1878-6480 |
| DOI: | 10.1016/j.acvdsp.2018.10.344 |
| Popis: | International audience; Background: Radiotherapy (RT) is a major component of breast cancer treatment and advanced RT techniques allowed reducing irradiation of healthy tissue. However, the heart often remains partially exposed. Detailed individual heart dosimetry information is required to better understand radiation-induced cardiac damage. Purpose: To analyze the distribution of individually-determined radiation dose to the heart and its substructures, in particular coronary arteries, after RT in breast cancer patients from the BACCARAT cohort. Methods: BACCARAT is a monocentric prospective cohort study that included unilateral breast cancer patients treated with RT between 2015 and 2017 and followed for 2 years with repeated cardiac imaging examinations, including coronary computed tomography angiography. Using the 3D dose matrix generated during RT treatment planning and the added coronary contours, dose distributions were generated for the following cardiac structures: whole heart, left ventricle (LV), left main coronary artery (LM), left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA). A descriptive analysis of the physical doses in Gray (Gy) was performed.Results: Dose distributions were generated for 59 patients (50 left-sided breast cancer, 9 right-sided) who all received a treatment of 50 Gy to the breast. The mean heart dose was 2.98 Gy for left sided patients and 0.42 Gy for right sided and mean LV doses were respectively 6.23 Gy and 0.09 Gy. For left-sided patients, mean dose to LM (D_LM)=1.29 Gy, D_LAD=16.32 Gy, D_LCX=1.59 Gy and D_RCA=0.67Gy, whereas corresponding doses for right-sided patients were D_LM=0.35 Gy, D_LAD=0.11 Gy, D_LCX=0.14 Gy and D_RCA=1.10 Gy. For left sided patients, the most exposed part of the LAD could receive doses > 45 Gy.Conclusion: Our study illustrates the wide range of doses experienced by the heart substructures and thus the poor significance of the mean heart dose as a radiation damage indicator. Keywords: Radiotherapy; Breast Cancer; Radiation Dosimetry; Cardiotoxicity |
| Databáze: | OpenAIRE |
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