Anatomy-dependent lung doses from 3D-conformal breast-cancer radiotherapy

0559073 - ÚJF 2023 RIV DE eng J - Journal Article
Kundrát, Pavel - Rennau, H. - Remmele, J. - Sebb, S. - Simonetto, C. - Kaiser, J. - Hildebrandt, G. - Wolf, U. - Eidemuller, M.
Anatomy-dependent lung doses from 3D-conformal breast-cancer radiotherapy.
Scientific Reports. Roč. 12, č. 1 (2022), č. článku 10909. ISSN 2045-2322. E-ISSN 2045-2322
Institutional support: RVO:61389005
Keywords : breast-cancer * radiotherapy * 3D-conformal
OECD category: Radiology, nuclear medicine and medical imaging
Impact factor: 4.6, year: 2022
Method of publishing: Open access
https://doi.org/10.1038/s41598-022-14149-2

This study aims to identify key anatomic features that govern the individual variability of lung doses from breast-cancer radiotherapy. 3D conformal, intensity-modulated and hybrid techniques with 50.4 Gy whole-breast dose were planned for 128 patients. From their CT images, 17 anatomic measures were assessed and tested as predictors for lung dose-volume characteristics. Tangential techniques yielded mean ipsilateral lung doses in the range of 3-11 Gy. This inter-patient variability was explained to almost 40% by central lung distance, and to almost 60% if this measure was complemented by midplane lung width and maximum heart distance. Also the variability in further dose-volume metrics such as volume fractions receiving 5, 20 or 40 Gy could be largely explained by the anatomy. Multi-field intensity-modulated radiotherapy reduced high-exposed lung volumes, but resulted in higher mean ipsilateral lung doses and larger low-dose burden. Contralateral lung doses ranged from 0.3 to 1 Gy. The results highlight that there are large differences in lung doses among breast-cancer patients. Most of this inter-individual variability can be explained by a few anatomic features. The results will be implemented in a dedicated software tool to provide personalized estimates of long-term health risks related to breast-cancer radiotherapy. The results may also be used to identify favourable as well as problematic anatomies, and serve as a quick quantitative benchmark for individual treatment plans.
Permanent Link: https://hdl.handle.net/11104/0332491