PMID- 33807209
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 57
IP  - 4
DP  - 2021 Mar 31
TI  - A Pilot Study of Safer Radiation Dosage to the Heart and Its Subregions.
LID - 10.3390/medicina57040320 [doi]
LID - 320
AB  - Background and Objectives: The real impact of ionizing radiation on the heart and 
      poorer overall survival for patients with non small cell lung cancer (NSCLC) 
      remains unclear. This study aims to determine the safe dose constraints to the 
      heart's subregions that could prevent patients' early non-cancerous death and 
      improve their quality of life. Methods and Materials: A retrospective cohort 
      study was performed containing 51 consecutive patients diagnosed with stage III 
      NSCLC and treated using 3D, Intensity-modulated radiation therapy (IMRT), and 
      Volumetric modulated arc therapy (VMAT) radiotherapy. For a dosimetric analysis, 
      these structures were chosen: heart, heart base (HB), and region of great blood 
      vessels (GBV). Dose-volume histograms (DVH) were recorded for all mentioned 
      structures. Maximum and mean doses to the heart, HB, the muscle mass of the HB, 
      and GBV were obtained. V10-V60 (%) parameters were calculated from the DVH. After 
      performed statistical analysis, logistic regression models were created, and 
      critical doses calculated. Results: The critical dose for developing a fatal 
      endpoint for HB was 30.5 Gy, while for GBV, it was 46.3 Gy. Increasing the 
      average dose to the HB or GBV by 1 Gy from the critical dose further increases 
      the possibility of early death by 22.0% and 15.8%, respectively. Conclusions: We 
      suggest that the non-canonical sub-regions of the heart (HB and GBV) should be 
      considered during the planning stage. Additional constraints of the heart 
      subregions should be chosen accordingly, and we propose that the mean doses to 
      these regions be 30.5 Gy and 46.3 Gy, respectively, or less. Extrapolated DVH 
      curves for both regions may be used during the planning stage with care.
FAU - Steponaviciene, Rita
AU  - Steponaviciene R
AD  - External Beam Radiotherapy Department, National Cancer Institute, Santariskiu 
      Str. 1, LT-08406 Vilnius, Lithuania.
FAU - Jonusas, Justinas
AU  - Jonusas J
AD  - Vilnius University Hospital Santaros Klinikos, Santariskiu Str. 2, LT-08410 
      Vilnius, Lithuania.
FAU - Griskevicius, Romualdas
AU  - Griskevicius R
AD  - Medical Physics Department, National Cancer Institute, Santariskiu Str. 1, 
      LT-08406 Vilnius, Lithuania.
FAU - Venius, Jonas
AU  - Venius J
AD  - Medical Physics Department, National Cancer Institute, Santariskiu Str. 1, 
      LT-08406 Vilnius, Lithuania.
AD  - Laboratory of Biomedical Physics, National Cancer Institute, Baublio 3b, LT-08406 
      Vilnius, Lithuania.
FAU - Cicenas, Saulius
AU  - Cicenas S
AD  - Department of Thoracic Surgery and Oncology, National Cancer Institute, 
      Santariskiu Str. 1, LT-08406 Vilnius, Lithuania.
LA  - eng
PT  - Journal Article
DEP - 20210331
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
SB  - IM
MH  - *Carcinoma, Non-Small-Cell Lung/radiotherapy
MH  - Humans
MH  - *Lung Neoplasms
MH  - Pilot Projects
MH  - Quality of Life
MH  - Radiation Dosage
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - Retrospective Studies
PMC - PMC8065397
OTO - NOTNLM
OT  - IMRT
OT  - NSCLC
OT  - heart base
OT  - pulmonary artery
COIS- The authors declare no conflict of interest.
EDAT- 2021/04/04 06:00
MHDA- 2021/05/15 06:00
PMCR- 2021/03/31
CRDT- 2021/04/03 01:26
PHST- 2021/03/02 00:00 [received]
PHST- 2021/03/23 00:00 [revised]
PHST- 2021/03/26 00:00 [accepted]
PHST- 2021/04/03 01:26 [entrez]
PHST- 2021/04/04 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2021/03/31 00:00 [pmc-release]
AID - medicina57040320 [pii]
AID - medicina-57-00320 [pii]
AID - 10.3390/medicina57040320 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2021 Mar 31;57(4):320. doi: 10.3390/medicina57040320.