Abstract
Purpose: To describe cardiac exposure from breast cancer radiotherapy regimens used during 1970–2009 for the development of dose–response relationships and to consider the associated radiation-risks using existing dose–response relationships. Material and methods: Radiotherapy charts for 771 women in the Netherlands selected for case control studies of heart disease after breast cancer radiotherapy were used to reconstruct 44 regimens on a typical CT-dataset. Doses were estimated for the whole heart (WH), left ventricle (LV) and cardiac valves. Results: For breast/chest wall radiotherapy average WH doses decreased during 1970–2009. For internal mammary chain (IMC) radiotherapy WH doses were highest during the 1980s and 1990s when direct anterior fields were used and reduced in the 2000s when oblique fields were introduced. Average doses varied substantially for IMC regimens (WH 2–33 Gy, LV < 1–23 Gy). For cardiac valves, at least one valve received >30 Gy from most regimens. Conclusions: Radiation-risks of IHD from breast/chest wall regimens likely reduced during 1970–2009. Direct anterior IMC regimens likely increased the risks of IHD and VHD over this time period but the use of oblique IMC fields from 2003 may have lowered these risks. These data provide a unique opportunity to develop dose–response relationships.
Original language | English |
---|---|
Pages (from-to) | 132-139 |
Number of pages | 8 |
Journal | Clinical and Translational Radiation Oncology |
Volume | 36 |
Early online date | 15 Jul 2022 |
DOIs | |
Publication status | Published - 1 Sept 2022 |
Bibliographical note
Funding Information:This work was funded by a Medical Research Council UK Clinical Research Fellowship grant, a Cancer Research UK grant C8225/A21133, PRCRPG-Nov21\100001) and a British Heart Foundation Centre for Research Excellence, Oxford grant RE/13/1/30181. It was also supported by the Dutch Cancer Society (grant NKI 2008-3994) and Pink Ribbon (grant 2012.WO39.C143).
Publisher Copyright:
© 2022 The Author(s)