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European Journal of Medical Research

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Open Access 01-12-2023 | Radiotherapy | Research

Cardiac protective techniques in left breast radiotherapy: rapid selection criteria for routine clinical decision making

Authors: Meltem Kirli Bolukbas, Sibel Karaca, Volkan Coskun, Esengul Kocak Uzel

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Objective

In left breast radiotherapy (RT) desired heart doses may be achieved without heart-sparing RT techniques in some patients. We aimed to examine the existence of predictive factors and cutoff points to determine which patients are the main candidates for heart-sparing RT techniques.

Material and method

Dosimetric data for left breast cancer was examined. RT plans were made at conventional doses to the breast and peripheral lymph nodes. Statistical analyses were performed using SPSS 22.0 (SPSS Inc., IBM Corp., Armonk, NY).

Result

114 cases were evaluated by ROC (Receiver operating characteristic) analysis in the breast-conserving surgery (BCS) and mastectomy groups. While only left lung volume (AUC: 0.74, 95% CI 0.61–0.87, p = 0.002) was significant in BCS cases, in cases with mastectomy, left lung volume (AUC: 0.81, 95% CI 0.69–0.94, p = 0.002) and lung/heart volume ratio (AUC: 0.83, 95% CI 0.70–0.96, p = 0.001) had a significant relationship with the relevance of heart doses. The cutoff point of 1.92 was selected for the lung/heart volume ratio for the mastectomized patients. Moreover, the cutoff point 1154 cc and 1208 cc was determined for the left lung volume for the BCS and mastectomized patients, respectively.

Conclusion

Various cutoff points in left breast RT can be used to predict whether RT plans will meet QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic) heart dose limits. Evaluating only these few cutoff points before planning makes it possible to eliminate 70% of patients with BCS and 40% of patients with mastectomy from respiratory-controlled methods, which require time and effort. Patients with lung volume and lung/heart volume ratio smaller than the cutoff values can be considered primary candidates for heart-sparing techniques.

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Title: Cardiac protective techniques in left breast radiotherapy: rapid selection criteria for routine clinical decision making
Authors: Meltem Kirli Bolukbas
Sibel Karaca
Volkan Coskun
Esengul Kocak Uzel
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Radiotherapy
Breast Cancer
Breast Cancer
Mastectomy
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01470-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cardiac protective techniques in left breast radiotherapy: rapid selection criteria for routine clinical decision making

Abstract

Objective

Material and method

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Material and method

Result

Conclusion

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