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Kundrat, P. ; Remmele, J.* ; Rennau, H.* ; Sebb, S.* ; Simonetto, C. ; Eidemüller, M. ; Wolf, U.* ; Hildebrandt, G.*

Minimum breast distance largely explains individual variability in doses to contralateral breast from breast-cancer radiotherapy.

Radiother. Oncol. 131, 186-191 (2019)
Postprint DOI PMC
Open Access Green
Purpose: To provide personalized estimates of doses to contralateral breast (CB) from breast-cancer radiotherapy.Methods: Whole-breast irradiations using 3D conformal, intensity-modulated and hybrid techniques with 50.4 Gy prescribed dose were planned for 128 breast-cancer patients. From their CT images, 17 anatomic measures were assessed and tested by model fitting as predictors for CB dose-volume characteristics.Results: Multi-field intensity-modulated radiotherapy (IMRT) yielded mean CB doses of 0.8-7.1 Gy, with no correlation to the studied anatomic parameters. Tangential whole-breast irradiation led to much lower mean CB doses, 0.2-1.6 Gy. About 60% of this inter-patient variability was explained by individual variations in a single anatomic measure, the minimum breast distance (MBD), defined as the CB distance from the tangent to the treated breast. Per 1 cm increase in MBD, the mean CB dose decreased by 10-15%. As an alternative to MBD, dose estimates could be based on the breast-to-breast distance, which is highly correlated with MBD.Conclusion: The results enable personalized assessment of CB doses from tangential whole-breast irradiation, based only on parameters assessable from CT data. This may help support clinical decision-making processes as well as analyse retrospective studies on CB risks. (C) 2018 Elsevier B.V. All rights reserved.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Breast-cancer Radiotherapy ; Contralateral Breast ; Individual Variability ; Anatomic Parameters; Radiation-therapy Imrt; Tangential Fields; Secondary-cancer; 2nd Primary; Risk; Heart; Recurrence; Lung
ISSN (print) / ISBN 0167-8140
e-ISSN 1879-0887
Journal Radiotherapy and Oncology
Quellenangaben Volume: 131, Issue: , Pages: 186-191 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Protection (ISS)