Radiation dose distribution in coronary arteries in breast cancer radiotherapy

Authors

  • Greger Nilsson Department of Immunology, Genetics and Pathology, Section of Experimental and Clinical Oncology, Uppsala University, University Hospital, Uppsala, Sweden; Department of Oncology, Gävle Hospital, Gävle, Sweden; Section of Oncology, Visby Hospital, Visby, Sweden
  • Petra Witt Nyström Department of Immunology, Genetics and Pathology, Section of Experimental and Clinical Oncology, Uppsala University, University Hospital, Uppsala, Sweden
  • Ulf Isacsson Department of Immunology, Genetics and Pathology, Section of Medical Radiation Science, Uppsala University, University Hospital, Uppsala, Sweden
  • Hans Garmo King's College London, Faculty of Life Sciences and Medicine, Division of Cancer Studies, Guy's Campus, London, UK; Regional Cancer Center, Uppsala University, University Hospital, Uppsala, Sweden
  • Olov Duvernoy Department of Surgical Sciences, Section of Radiology, Uppsala University, University Hospital, Uppsala, Sweden
  • Iwar Sjögren Department of Cardiology, Falu Hospital, Falun, Sweden
  • Bo Lagerqvist Department of Medical Sciences, Section of Cardiology, Uppsala University; Uppsala Clinical Research Centre, Uppsala University, University Hospital, Uppsala, Sweden; Uppsala University, University Hospital, Uppsala, Sweden; Uppsala Clinical Research Centre, Uppsala University, University Hospital, Uppsala, Sweden
  • Lars Holmberg King's College London, Faculty of Life Sciences and Medicine, Division of Cancer Studies, Guy's Campus, London, UK; Department of Surgical Sciences, Section of Endocrine Surgery, Uppsala University, University Hospital, Uppsala, Sweden
  • Carl Blomqvist Department of Oncology, Örebro University, University Hospital, Örebro, Sweden

DOI:

https://doi.org/10.1080/0284186X.2016.1182209

Abstract

Background: Women irradiated for left-sided breast cancer (BC) have an increased risk of coronary artery disease compared to women with right-sided BC. We describe the distribution of radiation dose in segments of coronary arteries in women receiving adjuvant radiotherapy (RT) for left- or right-sided BC.

Material and methods: Fifteen women with BC, seven left-sided and eight right-sided, who had received three-dimensional conformal radiotherapy (3DCRT), constituted the study base. The heart and the segments of the coronary arteries were defined as separate organs at risk (OAR), and the mean and maximum radiation doses were calculated for each OAR.

Results: In women with left-sided BC, irrespective of if regional lymph node RT was given or not, maximum dose in mid and distal left anterior descending artery (mdLAD) was approximately 50 Gy in 6/7 patients, whereas women with right-sided BC mainly received low doses of radiation. In women with left-sided BC, 6/7 patients had substantially higher mean dose to the distal LAD than to the heart, ranging from 30 to 55 Gy and 3 to13 Gy, respectively.

Conclusion: We found a pronounced difference of radiation dose distribution in the coronary arteries between women with left- and right-sided BC. Women with left-sided BC had almost full treatment dose in parts of mdLAD, regardless of if regional lymph node irradiation was given or not, while women with right-sided BC mainly received low doses to the coronary arteries.

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Published

2016-08-02

How to Cite

Nilsson, G., Witt Nyström, P., Isacsson, U., Garmo, H., Duvernoy, O., Sjögren, I., … Blomqvist, C. (2016). Radiation dose distribution in coronary arteries in breast cancer radiotherapy. Acta Oncologica, 55(8), 959–963. https://doi.org/10.1080/0284186X.2016.1182209

Issue

Vol. 55 No. 8 (2016): Acta Oncologica

Section

Articles