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Radiotherapy and heart

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https://www.readbyqxmd.com/read/28440606/pathogenesis-and-prevention-of-radiation-induced-myocardial-fibrosis
#1
Li Kun Liu, Weiwei Ouyang, Xing Zhao, Sheng Fa Su, Yan Yang, Wen Jin Ding, Da Xian Luo, Zhi Xu He, Bing Lu
Radiation therapy is one of the most important methods for the treatment of malignant tumors. However, in radiotherapy for thoracic tumors such as breast cancer, lung cancer, esophageal cancer, and mediastinal lymphoma, the heart, located in the mediastinum, is inevitably affected by the irradiation, leading to pericardial disease, myocardial fibrosis, coronary artery disease, valvular lesions, and cardiac conduction system injury, which are considered radiation-induced heart diseases. Delayed cardiac injury especially myocardial fibrosis is more prominent, and its incidence is as high as 20–80%...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28424841/dosimetric-predictors-of-radiation-induced-pericardial-effusion-in%C3%A2-esophageal-cancer
#2
Ichiro Ogino, Shigenobu Watanabe, Kentaro Sakamaki, Yuka Ogino, Chikara Kunisaki, Kazuo Kimura
PURPOSE: To evaluate the dose-volume parameters of the pericardium and heart in order to reduce the risk of radiation-induced pericardial effusion (PE) and symptomatic PE (SPE) in esophageal cancer patients treated with concurrent chemoradiotherapy. METHODS: In 86 of 303 esophageal cancer patients, follow-up CT was obtained at least 24 months after concurrent chemoradiotherapy. Correlations between clinical factors, including risk factors for cardiac disease, dosimetric factors, and the incidence of PE and SPE after radiotherapy were analyzed using Cox proportional hazard regression analysis...
April 19, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28421397/comparison-between-the-four-field-box-and-field-in-field-techniques-for-conformal-radiotherapy-of-the-esophagus-using-dose-volume-histograms-and-normal-tissue-complication-probabilities
#3
Farzaneh Allaveisi, Amir Nami Moghadam
PURPOSE: We evaluated and compared the performance of the field-in-field (FIF) to that of the four-field box (4FB) technique regarding dosimetric and radiobiological parameters for radiotherapy of esophageal carcinoma. MATERIALS AND METHODS: Twenty patients with esophageal cancer were selected. For each patient, two treatment plans were created: 4FB and FIF. The parameters compared included the conformity index (CI), homogeneity index (HI), D mean, D max, tumor control probability (TCP), V 20Gy and V 30Gy of the heart and lungs, normal tissue complication probability (NTCP), and monitor units per fraction (MU/fr)...
April 18, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28419246/quality-assurance-for-a-multicenter-phase-ii-study-of-stereotactic-ablative-radiotherapy-for-hepatocellular-carcinoma-%C3%A2-5-cm-a-planning-dummy-run
#4
Sun Hyun Bae, Mi-Sook Kim, Won Il Jang, Kum Bae Kim, Kwang Hwan Cho, Woo Chul Kim, Chang Yeol Lee, Eun Seog Kim, Chul Won Choi, A Ram Chang, Sunmi Jo, Jin-Young Kim
Objective: The Korean Radiation Oncology Group (12-02) investigated the outcome of stereotactic ablative radiotherapy for hepatocellular carcinoma ≤5 cm using 60 Gy in three fractions. To evaluate dosimetric differences and compliance in a multicenter trial, a planning dummy run procedure was performed. Methods: All six participating institutions were provided the contours of two dummy run cases. Plans were performed following the study protocol to cover the planning target volume with a minimum of 90% of the prescription dose and to satisfy the constraints for organs at risk...
April 13, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28417333/immediate-tissue-expander-or-implant-based-breast-reconstruction-does-not-compromise-the-oncologic-delivery-of-post-mastectomy-radiotherapy-pmrt
#5
Krishan R Jethwa, Mohamed M Kahila, Thomas J Whitaker, William S Harmsen, Kimberly S Corbin, Sean S Park, Elizabeth S Yan, Valerie Lemaine, Judy C Boughey, Robert W Mutter
PURPOSE: Increasingly, women are choosing immediate breast reconstruction (IBR) following mastectomy. Reports have indicated IBR may compromise post-mastectomy radiotherapy (PMRT). We investigated the impact of IBR on timing of PMRT, target coverage, and doses to organs at risk in a modern radiotherapy practice using advanced planning techniques. METHODS: Between 2013 and 2015, PMRT was delivered to 116 patients (66 mastectomy alone, 50 IBR). PMRT was delivered with a median dose of 50 Gy in 25 fractions...
April 17, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28410685/evaluation-of-mesh-and-binary-based-contour-propagation-methods-in-4d-thoracic-radiotherapy-treatments-using-patient-4d-ct-images
#6
Yuanyuan Ma, Xinguo Liu, Zhongying Dai, Pengbo He, Yuanlin Yan, Guosheng Shen, Ping Yuan, Qiang Li
Based on four dimensional (4D) computed tomography (CT) images, mesh- and binary-based contour propagation algorithms for 4D thoracic radiotherapy treatments were evaluated. Gross tumor volumes (GTVs), lungs, hearts and spinal cords on the CT images at the end-exhale and end-inhale phases for six patients were delineated by the physician. All volumes of interest (VOIs) were automatically propagated from the end-exhale phase to the end-inhale phase using two propagation methods. The propagated VOIs were quantitatively compared with the VOIs contoured at the end-inhale phase by the physician using Dice Similarity Coefficient (DSC), Mean Slicewise Hausdorff Distance (MSHD), Center Of Mass (COM) displacement and volume difference...
April 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28410144/cardiotoxicity-in-oncology-and-coronary-microcirculation-future-challenges-in-theranostics
#7
Giovanni Peretto, Davide Lazzeroni, Carmem L Sartorio, Paolo G Camici
Many of the patients undergoing chemotherapy or radiotherapy for cancer are at increased risk of developing cardiovascular diseases. Recent evidence suggests that cardiac dysfunction and subsequent heart failure are mainly due to vascular toxicity rather than only to due to myocyte toxicity. However, not all of the vascular toxicity of cancer therapies can be explained by epicardial coronary artery disease. In fact, in the last decades, it has been found that myocardial ischemia may occur as a consequence of structural or functional dysfunction of the complex network of vessels, which cannot be seen by a coronary angiography: the coronary microcirculation...
June 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28405101/the-feasibility-study-of-a-hybrid-coplanar-arc-technique-versus-hybrid-intensity-modulated-radiotherapy-in-treatment-of-early-stage-left-sided-breast-cancer-with-simultaneous-integrated-boost
#8
Yuan-Gui Chen, An-Chuan Li, Wen-Yao Li, Miao-Yun Huang, Xiao-Bo Li, Ming-Qiu Chen, Mutian Zhang, Ben-Hua Xu
This study demonstrated the feasibility and advantages of a hybrid, volumetric arc therapy technique that used two 90° coplanar arcs and two three-dimensional conformal tangential beams in the simultaneous-integrated boost radiotherapy of left-sided breast cancer after breast-conserving surgery. A total of nine patients with stage I, left-sided breast cancer who underwent breast-conserving surgery were selected for this retrospective study. For each patient, a hybrid arc plan was generated and then compared with two hybrid intensity-modulated radiotherapy plans...
January 2017: Journal of Medical Physics
https://www.readbyqxmd.com/read/28402279/intensity-modulated-radiotherapy-with-fixed-collimator-jaws-for-locoregional-left-sided-breast-cancer-irradiation
#9
Juanqi Wang, Zhaozhi Yang, Weigang Hu, Zhi Chen, Xiaoli Yu, Xiaomao Guo
The purpose of this study is to evaluate the intensity modulated radiotherapy (IMRT) with the fixed collimator jaws technique (FJT) for the left breast and regional lymph node. The targeted breast tissue and the lymph nodes, and the normal tissues were contoured for 16 left-sided breast cancer patients previously treated with radiotherapy after lumpectomy. For each patient, treatment plans using different planning techniques, i.e., volumetric modulated arc therapy (VMAT), tangential IMRT (tangential-IMRT), and IMRT with FJT (FJT-IMRT) were developed for dosimetric comparisons...
March 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28398210/out-of-field-doses-from-pediatric-craniospinal-irradiations-using-3d-crt-imrt-helical-tomotherapy-and-electron-based-therapy
#10
Marijke De Saint-Hubert, Dirk Verellen, Kenneth Poels, Wouter Crijns, Federica Magliona, Tom Depuydt, Filip Vanhavere, Lara Struelens
Medulloblastoma treatment involves irradiation of the entire central nervous system, i.e craniospinal irradiation (CSI). This is associated with significant exposure of large volumes of healthy tissue with a growing concern regarding treatment associated side effects. The current study compares out-of-field organ doses in children receiving CSI with three-dimensional-conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT), helical tomotherapy (HT) and an electron-based technique, including as well radiation doses resulting from imaging performed during treatment...
April 11, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28392465/l-carnitine-preserves-cardiac-function-by-activating-p38-mapk-nrf2-signalling-in-hearts-exposed-to-irradiation
#11
Zhigang Fan, Yang Han, Yuanpeng Ye, Chao Liu, Hui Cai
Radiation-induced heart damage (RIHD) is now considered to be one of the causes of mortality in cancer patients undergoing radiotherapy. Cardiac function impairments are clinical manifestations of RIHD. L-carnitine shows protective effects against irradiation and heart disease. This study was aimed to investigate the cardioprotective effects and potential molecular mechanisms of L-carnitine against RIHD. Mouse hearts were exposed to γ-radiation to induce RIHD. L-carnitine at doses of 100mg/Kg and 200mg/Kg was used to treat animals intraperitoneally...
June 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28365830/optimal-therapy-for-early-stage-hodgkin-s-lymphoma-risk-adapting-response-adapting-and-role-of-radiotherapy
#12
REVIEW
Andrea Riccardo Filippi, Mario Levis, Rahul Parikh, Bradford Hoppe
PURPOSE OF REVIEW: The aim of this article is to discuss the current role of radiotherapy (RT) for early-stage Hodgkin's lymphoma (HL) in the context of risk-adapted and response-adapted treatment strategy, and describe changes in RT technical approach. RECENT FINDINGS: In low-risk patients, RT could be omitted but, at the price of a lower progression-free survival, and its role is still debated. Ongoing trials are combining new agents with chemotherapy alone or response-adapted combined modality therapy, and results are awaited...
May 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28365142/risk-of-heart-disease-in-relation-to-radiotherapy-and-chemotherapy-with-anthracyclines-among-19-464-breast-cancer-patients-in-denmark-1977-2005
#13
Jens Christian Rehammar, Maj-Britt Jensen, Paul McGale, Ebbe Laugaard Lorenzen, Carolyn Taylor, Sarah C Darby, Lars Videbæk, Zhe Wang, Marianne Ewertz
BACKGROUND AND PURPOSE: The risk of heart disease subsequent to breast cancer radiotherapy was examined with particular focus on women receiving anthracycline-containing chemotherapy. MATERIAL AND METHODS: Women diagnosed with early-stage breast cancer in Denmark, 1977-2005, were identified from the register of the Danish Breast Cancer Cooperative Group, as was information on cancer-directed treatment. Information on heart disease was sought from the Danish National Patient and Cause of Death Registries...
March 29, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28364270/safe-trial-an-ongoing-randomized-clinical-study-to-assess-the-role-of-cardiotoxicity-prevention-in-breast-cancer-patients-treated-with-anthracyclines-with-or-without-trastuzumab
#14
REVIEW
Icro Meattini, Giuseppe Curigliano, Francesca Terziani, Carlotta Becherini, Mario Airoldi, Giacomo Allegrini, Domenico Amoroso, Sandro Barni, Carmelo Bengala, Valentina Guarneri, Paolo Marchetti, Francesca Martella, Pierluigi Piovano, Agnese Vannini, Isacco Desideri, Roberto Tarquini, Giorgio Galanti, Giuseppe Barletta, Lorenzo Livi
Over the years, thanks to the addition of new generation systemic agents, as well as the use of more advanced and precise radiotherapy techniques, it was able to obtain a high curability rate for breast cancer. Anthracyclines play a key role in the treatment of breast disease, with a well-known benefit on disease-free survival of patients with positive nodal status. Trastuzumab have shown a significant outcome advantage after 1-year administration in case of HER2-positive disease. Unfortunately, significant increase in cardiotoxicity has been observed after anthracyclines and trastuzumab therapies...
May 2017: Medical Oncology
https://www.readbyqxmd.com/read/28362511/effect-of-accurate-heart-delineation-on-cardiac-dose-during-the-convert-trial
#15
Nicki Groom, Elena Wilson, Corinne Faivre-Finn
OBJECTIVES: This study investigates the effect of deviation from protocol in heart delineation for the CONVERT Trial ( ClinicalTrials.gov Identifier NCT00433563) quality assurance (QA) programme, and the effect of that on mean cardiac dose and percentage of heart volume receiving ≥5Gy (V5%) and ≥30Gy (V30%). METHODS: CONVERT trial patients with limited-stage small-cell lung cancer (LS SCLC) were randomised to receive 45Gy in 30# BD or 66Gy in 33# OD radiotherapy, with concurrent chemotherapy in both arms...
March 31, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28353062/self-reported-long-term-cardiac-morbidity-in-breast-cancer-patients-a-retrospective-cohort-study-in-germany-passos-heart-study
#16
Daniel Wollschläger, Hiltrud Merzenich, Lukas Schwentner, Wolfgang Janni, Thomas Wiegel, Detlef Bartkowiak, Achim Wöckel, Marcus Schmidt, Heinz Schmidberger, Maria Blettner
PURPOSE: Improved survival after locoregional breast cancer has increased the concern about late adverse effects after therapy. In particular, radiotherapy was identified as a risk factor for major cardiac events in women treated until the 1990s. While modern radiotherapy with computerized planning based on 3D-imaging can help spare organs at risk, heart exposure may remain substantial. In a retrospective cohort study of women treated for locoregional breast cancer, we investigated whether current radiotherapy is associated with an elevated long-term cardiac morbidity risk...
March 28, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28343538/accelerated-hypofractionated-adjuvant-whole-breast-radiation-with-simultaneous-integrated-boost-using-volumetric-modulated-arc-therapy-for-early-breast-cancer-a-phase-i-ii-dosimetric-and-clinical-feasibility-study-from-a-tertiary-cancer-care-centre-of-india
#17
Dodul Mondal, Pramod Kumar Julka, Daya Nand Sharma, Manisha Jana, Macharla Anjaneyelu Laviraj, Suryanarayan Vs Deo, Soumyajit Roy, Randeep Guleria, Goura K Rath
BACKGROUND: Hypofractionation has become standard of care after Breast Conserving Therapy (BCT) in many European and few others western countries. Though still debatable, tumor cavity boost is routinely practised in our centre. Hypofractionation is not yet the current standard of practice in Asian countries. Employing hypofractionation and simultaneous integrated boost to lumpectomy cavity with conformal technique is not the current practice in this region. Hence the study was performed to see whether accelerated hypofractionation and simultaneous boost can be combined using volumetric modulated arc therapy (VMAT) in treating early breast cancer (EBC) patients...
March 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/28327923/heart-dose-exposure-as-prognostic-marker-after-radiotherapy-for-resectable-stage-iiia-b-non-small-cell-lung-cancer-secondary-analysis-of-a-randomised-trial
#18
M Guberina, W Eberhardt, M Stuschke, T Gauler, F Heinzelmann, D Cheufou, M Kimmich, G Friedel, H Schmidberger, K Darwiche, V Jendrossek, M Schuler, G Stamatis, C Pöttgen
BACKGROUND: Heart exposure to ionizing irradiation can cause ischemic heart disease. The partial heart volume receiving ≥5 Gy (heartV5) was supposed to be an independent prognostic factor for survival after radiochemotherapy for locally advanced non-small cell lung cancer (NSCLC). But validation of the latter hypothesis is needed under the concurrent risks of lung cancer patients. PATIENTS AND METHODS: The ESPATUE phase III trial recruited patients with potentially operable IIIA(N2)/selected IIIB NSCLC between 01/2004 and 01/2013...
February 21, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28320428/a-topology-based-method-to-mitigate-the-dosimetric-uncertainty-caused-by-the-positional-variation-of-the-boost-volume-in-breast-conservative-radiotherapy
#19
Peng-Yi Lee, Chih-Yuan Lin, Shang-Wen Chen, Chun-Ru Chien, Chun-Nan Chu, Hsiu-Ting Hsu, Ji-An Liang, Ying-Jun Lin, An-Cheng Shiau
BACKGROUND: To improve local control rate in patients with breast cancer receiving adjuvant radiotherapy after breast conservative surgery, additional boost dose to the tumor bed could be delivered simultaneously via the simultaneous integrated boost (SIB) modulated technique. However, the position of tumor bed kept changing during the treatment course as the treatment position was aligned to bony anatomy. This study aimed to analyze the positional uncertainties between bony anatomy and tumor bed, and a topology-based approach was derived to stratify patients with high variation in tumor bed localization...
March 20, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28319436/estimating-the-risks-of-breast-cancer-radiotherapy-evidence-from-modern-radiation-doses-to-the-lungs-and-heart-and-from-previous-randomized-trials
#20
Carolyn Taylor, Candace Correa, Frances K Duane, Marianne C Aznar, Stewart J Anderson, Jonas Bergh, David Dodwell, Marianne Ewertz, Richard Gray, Reshma Jagsi, Lori Pierce, Kathleen I Pritchard, Sandra Swain, Zhe Wang, Yaochen Wang, Tim Whelan, Richard Peto, Paul McGale
Purpose Radiotherapy reduces the absolute risk of breast cancer mortality by a few percentage points in suitable women but can cause a second cancer or heart disease decades later. We estimated the absolute long-term risks of modern breast cancer radiotherapy. Methods First, a systematic literature review was performed of lung and heart doses in breast cancer regimens published during 2010 to 2015. Second, individual patient data meta-analyses of 40,781 women randomly assigned to breast cancer radiotherapy versus no radiotherapy in 75 trials yielded rate ratios (RRs) for second primary cancers and cause-specific mortality and excess RRs (ERRs) per Gy for incident lung cancer and cardiac mortality...
March 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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