| Zdroj: |
Duane, F K, McGale, P, Brønnum, D, Cutter, D J, Darby, S C, Ewertz, M, Hackett, S, Hall, P, Lorenzen, E L, Rahimi, K, Wang, Z, Warren, S & Taylor, C W 2019, ' Cardiac structure doses in women irradiated for breast cancer in the past and their use in epidemiological studies ', Practical Radiation Oncology, vol. 9, no. 3, pp. 158-171 . https://doi.org/10.1016/j.prro.2019.01.004 |
| Popis: |
Purpose: Incidental cardiac exposure during radiation therapy may cause heart disease. Dose-response relationships for cardiac structures (segments) may show which ones are most sensitive to radiation. Radiation-related cardiac injury can take years to develop; thus, studies need to involve women treated using 2-dimensional planning, with segment doses estimated using a typical computed tomography (CT) scan. We assessed whether such segment doses are accurate enough to use in dose-response relationships using the radiation therapy charts of women with known segment injury. We estimated interregimen and interpatient segment dose variability and segment dose correlations. Methods and Materials: The radiation therapy charts of 470 women with cardiac segment injury after breast cancer radiation therapy were examined, and 41 regimens were identified. Regimens were reconstructed on a typical CT scan. Doses were estimated for 5 left ventricle (LV) and 10 coronary artery segments. Correlations between cardiac segments were estimated. Interpatient dose variation was assessed in 10 randomly selected CT scans for left regimens and in 5 for right regimens. Results: For the typical CT scan, interregimen segment dose variation was substantial (range, LV segments Conclusions:The scope for developing quantitative cardiac segment dose-response relationships in patients who had 2-dimensional planning is limited because different segment doses are often highly correlated, and segment-specific dose uncertainties are not independent of each other. However, segment-specific doses may be reliably used to rank segments according to higher-versus-lower doses. |
