Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease: Effects of modern radiotherapy techniques Linksseitiger Brustkrebs und das Risiko von Sekundärmalignomen der Lunge und ischämischen Herzerkrankungen: Auswirkungen moderner Strahlentherapietechniken
Corradini S, Ballhausen H, Weingandt H, Freislederer P, Schönecker S, Niyazi M, Simonetto C, Eidemüller M, Ganswindt U, Belka C (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 194
Pages Range: 196-205
Journal Issue: 3
DOI: 10.1007/s00066-017-1213-y
Abstract
Purpose: Modern breast cancer radiotherapy techniques, such as respiratory-gated radiotherapy in deep-inspiration breath-hold (DIBH) or volumetric-modulated arc radiotherapy (VMAT) have been shown to reduce the high dose exposure of the heart in left-sided breast cancer. The aim of the present study was to comparatively estimate the excess relative and absolute risks of radiation-induced secondary lung cancer and ischemic heart disease for different modern radiotherapy techniques. Methods: Four different treatment plans were generated for ten computed tomography data sets of patients with left-sided breast cancer, using either three-dimensional conformal radiotherapy (3D-CRT) or VMAT, in free-breathing (FB) or DIBH. Dose–volume histograms were used for organ equivalent dose (OED) calculations using linear, linear–exponential, and plateau models for the lung. A linear model was applied to estimate the long-term risk of ischemic heart disease as motivated by epidemiologic data. Excess relative risk (ERR) and 10-year excess absolute risk (EAR) for radiation-induced secondary lung cancer and ischemic heart disease were estimated for different representative baseline risks. Results: The DIBH maneuver resulted in a significant reduction of the ERR and estimated 10-year excess absolute risk for major coronary events compared to FB in 3D-CRT plans (p = 0.04). In VMAT plans, the mean predicted risk reduction through DIBH was less pronounced and not statistically significant (p = 0.44). The risk of radiation-induced secondary lung cancer was mainly influenced by the radiotherapy technique, with no beneficial effect through DIBH. VMAT plans correlated with an increase in 10-year EAR for radiation-induced lung cancer as compared to 3D-CRT plans (DIBH p = 0.007; FB p = 0.005, respectively). However, the EARs were affected more strongly by nonradiation-associated risk factors, such as smoking, as compared to the choice of treatment technique. Conclusion: The results indicate that 3D-CRT plans in DIBH pose the lowest risk for both major coronary events and secondary lung cancer.
Involved external institutions
Klinikum der Universität München (LMU Klinikum)
Germany (DE)
Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (HMGU) / Helmholtz Munich
Germany (DE)
Germany (DE)
Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (HMGU) / Helmholtz Munich
Germany (DE)
How to cite
APA:
Corradini, S., Ballhausen, H., Weingandt, H., Freislederer, P., Schönecker, S., Niyazi, M.,... Belka, C. (2018). Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease: Effects of modern radiotherapy techniques Linksseitiger Brustkrebs und das Risiko von Sekundärmalignomen der Lunge und ischämischen Herzerkrankungen: Auswirkungen moderner Strahlentherapietechniken. Strahlentherapie und Onkologie, 194(3), 196-205. https://doi.org/10.1007/s00066-017-1213-y
MLA:
Corradini, Stefanie, et al. "Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease: Effects of modern radiotherapy techniques Linksseitiger Brustkrebs und das Risiko von Sekundärmalignomen der Lunge und ischämischen Herzerkrankungen: Auswirkungen moderner Strahlentherapietechniken." Strahlentherapie und Onkologie 194.3 (2018): 196-205.
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