The feasibility of a heart block with an electron compensation as an alternative whole breast radiotherapy technique in patients with underlying cardiac or pulmonary disease

We aimed to evaluate the feasibility of the heart block with electron compensation (HBE) technique, based on three-dimensional conformal radiotherapy (3D-CRT) in left-sided breast cancer patients with underlying cardiac or pulmonary disease. Twenty patients with left-sided breast cancer who were tre...

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Published in:PloS one 2017-09, Vol.12 (9), p.e0184137
Main Authors: Kang, Hye Jin, Kim, Shin-Wook, Son, Seok Hyun
Format: Article
Language:English
Subjects:
Adult
Biology
Biology and Life Sciences
Breast cancer
Breast Neoplasms - complications
Breast Neoplasms - radiotherapy
Cancer
Cancer patients
Cancer therapies
Care and treatment
Compensation
Coronary artery disease
Disease
Dosimetry
Drug dosages
Electrons
Feasibility Studies
Female
Health aspects
Heart
Heart Block
Heart diseases
Heart Diseases - complications
Hospitals
Humans
Lung diseases
Lung Diseases - complications
Lungs
Medical imaging
Medicine
Medicine and Health Sciences
Middle Aged
Oncology
Patients
Physical Sciences
Physics
Pulmonary arteries
Radiation
Radiation effects
Radiation Injuries - prevention & control
Radiation therapy
Radiometry
Radiotherapy
Radiotherapy - methods
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Conformal - methods
Research and Analysis Methods
Toxicity
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Kim, Shin-Wook
Son, Seok Hyun
description We aimed to evaluate the feasibility of the heart block with electron compensation (HBE) technique, based on three-dimensional conformal radiotherapy (3D-CRT) in left-sided breast cancer patients with underlying cardiac or pulmonary disease. Twenty patients with left-sided breast cancer who were treated with whole breast radiotherapy (WBRT) were included in this study. Intensity-modulated radiotherapy (IMRT), 3D-CRT, and HBE treatment plans were generated for each patient. Based on the 3D-CRT plan, the HBE plan included a heart block from the medial tangential field to shield the heart and added an electron beam to compensate for the loss in target volume coverage. The dosimetric parameters for the heart and lung and the target volume between the three treatment types were compared. Of the three plans, the HBE plan yielded the most significant reduction in the doses received by the heart and lung (heart Dmean: 5.1 Gy vs. 12.9 Gy vs. 4.0 Gy and lung Dmean: 11.4 Gy vs. 13.2 Gy vs. 10.5 Gy, for 3D-CRT, IMRT, and HBE, respectively). Target coverage with all three techniques was within the acceptable range (Dmean 51.0 Gy vs. 51.2 Gy vs. 50.6 Gy, for 3D-CRT, IMRT, and HBE, respectively). The HBE plan effectively reduced the amount of radiation exposure to the heart and lung. It could be beneficial for patients who are vulnerable to radiation-related cardiac or pulmonary toxicities.
doi_str_mv 10.1371/journal.pone.0184137
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Twenty patients with left-sided breast cancer who were treated with whole breast radiotherapy (WBRT) were included in this study. Intensity-modulated radiotherapy (IMRT), 3D-CRT, and HBE treatment plans were generated for each patient. Based on the 3D-CRT plan, the HBE plan included a heart block from the medial tangential field to shield the heart and added an electron beam to compensate for the loss in target volume coverage. The dosimetric parameters for the heart and lung and the target volume between the three treatment types were compared. Of the three plans, the HBE plan yielded the most significant reduction in the doses received by the heart and lung (heart Dmean: 5.1 Gy vs. 12.9 Gy vs. 4.0 Gy and lung Dmean: 11.4 Gy vs. 13.2 Gy vs. 10.5 Gy, for 3D-CRT, IMRT, and HBE, respectively). Target coverage with all three techniques was within the acceptable range (Dmean 51.0 Gy vs. 51.2 Gy vs. 50.6 Gy, for 3D-CRT, IMRT, and HBE, respectively). The HBE plan effectively reduced the amount of radiation exposure to the heart and lung. It could be beneficial for patients who are vulnerable to radiation-related cardiac or pulmonary toxicities.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28863179</pmid><doi>10.1371/journal.pone.0184137</doi><tpages>e0184137</tpages><orcidid>https://orcid.org/0000-0002-2577-1915</orcidid><oa>free_for_read</oa></addata></record>
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1932-6203
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recordid cdi_plos_journals_1934569954
source Publicly Available Content Database (Proquest) (PQ_SDU_P3); PubMed Central(OpenAccess)
subjects Adult
Biology
Biology and Life Sciences
Breast cancer
Breast Neoplasms - complications
Breast Neoplasms - radiotherapy
Cancer
Cancer patients
Cancer therapies
Care and treatment
Compensation
Coronary artery disease
Disease
Dosimetry
Drug dosages
Electrons
Feasibility Studies
Female
Health aspects
Heart
Heart Block
Heart diseases
Heart Diseases - complications
Hospitals
Humans
Lung diseases
Lung Diseases - complications
Lungs
Medical imaging
Medicine
Medicine and Health Sciences
Middle Aged
Oncology
Patients
Physical Sciences
Physics
Pulmonary arteries
Radiation
Radiation effects
Radiation Injuries - prevention & control
Radiation therapy
Radiometry
Radiotherapy
Radiotherapy - methods
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Conformal - methods
Research and Analysis Methods
Toxicity
title The feasibility of a heart block with an electron compensation as an alternative whole breast radiotherapy technique in patients with underlying cardiac or pulmonary disease
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