PMID- 34580051
OWN - NLM
STAT- MEDLINE
DCOM- 20211220
LR  - 20211220
IS  - 1876-7982 (Electronic)
IS  - 1876-7982 (Linking)
VI  - 52
IP  - 4
DP  - 2021 Dec
TI  - Dosimetry and outcomes in patients receiving radiotherapy for synchronous 
      bilateral breast cancers.
PG  - 527-543
LID - S1939-8654(21)00201-0 [pii]
LID - 10.1016/j.jmir.2021.08.013 [doi]
AB  - BACKGROUND: Synchronous bilateral breast cancer (SBBC) is rare and there is 
      little evidence describing organs at risk (OAR) and limits to the heart and lungs 
      caused by radiotherapy (RT). Quantifying mean heart dose (MHD) and mean lung dose 
      (MLD) from RT in this patient cohort may lead to better understanding of doses to 
      OAR and resultant effects on clinical outcomes. The primary objective was to 
      assess median MHD and MLD in SBBC, while secondary aims included analyses of 1) 
      factors associated with MHD and MLD, 2) V5 and V20 values and 3) factors 
      associated with clinical outcomes. METHODS: Patients planned for adjuvant 
      bilateral whole breast/chest wall (WB) RT from a single institution treated in 
      2011-2018 were included. Median MHD and MLD (Gy) were stratified by 
      hypofractionated (42.56 Gy/16 fractions, HFRT) and conventional fractionation (50 
      Gy/ 25 fractions, CFRT) and summarized separately based on the following 
      treatments: 1) locoregional RT, WB tangential RT either 2) no boost 3) sequential 
      boost or 4) simultaneous integrated boost. MHD, MLD, lung V5 and V20 values, and 
      demographics were collected. Linear regression analyses identified factors 
      associated with MHD and MLD and factors associated with clinical outcomes. 
      RESULTS: A total of 88 patients were included. The median MHD for HFRT and CFRT 
      was 1.99 Gy and 2.94 Gy, respectively. The median MLD for HFRT and CFRT was 6.00 
      Gy and 10.08 Gy, respectively. MHD and MLD were significantly associated with the 
      occurrence of a cardiac or pulmonary event post-radiation. Patients who had a 
      mastectomy or tumoral muscle involvement were more likely to develop a local 
      recurrence, metastasis or new primary while patients who had a lumpectomy or 
      tumor with a positive estrogen receptor status were less likely to experience 
      these events. CONCLUSIONS: Further investigation should be conducted to identify 
      SBBC RT techniques that mitigate dose to OARs to improve clinical outcomes in 
      bilateral breast patients.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - McKenzie, Erin
AU  - McKenzie E
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Razvi, Yasmeen
AU  - Razvi Y
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Bosnic, Sandi
AU  - Bosnic S
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Wronski, Matt
AU  - Wronski M
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Zhang, Liying
AU  - Zhang L
AD  - MacroStat Inc., Toronto, ON, Canada.
FAU - Karam, Irene
AU  - Karam I
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Donovan, Elysia
AU  - Donovan E
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Milton, Lauren
AU  - Milton L
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Behroozian, Tara
AU  - Behroozian T
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Drost, Leah
AU  - Drost L
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Yee, Caitlin
AU  - Yee C
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Wong, Gina
AU  - Wong G
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Lam, Emily
AU  - Lam E
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada.
FAU - Chow, Edward
AU  - Chow E
AD  - Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 
      Toronto, ON, Canada. Electronic address: Edward.Chow@sunnybrook.ca.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210924
PL  - United States
TA  - J Med Imaging Radiat Sci
JT  - Journal of medical imaging and radiation sciences
JID - 101469694
SB  - IM
MH  - *Breast Neoplasms/radiotherapy
MH  - Female
MH  - Heart
MH  - Humans
MH  - Mastectomy
MH  - Organs at Risk
MH  - Radiometry
OTO - NOTNLM
OT  - Bilateral breast cancer
OT  - Mean heart dosel mean lung dose
OT  - Outcomes
OT  - Radiotherapy
EDAT- 2021/09/29 06:00
MHDA- 2021/12/21 06:00
CRDT- 2021/09/28 05:48
PHST- 2021/07/05 00:00 [received]
PHST- 2021/08/16 00:00 [revised]
PHST- 2021/08/28 00:00 [accepted]
PHST- 2021/09/29 06:00 [pubmed]
PHST- 2021/12/21 06:00 [medline]
PHST- 2021/09/28 05:48 [entrez]
AID - S1939-8654(21)00201-0 [pii]
AID - 10.1016/j.jmir.2021.08.013 [doi]
PST - ppublish
SO  - J Med Imaging Radiat Sci. 2021 Dec;52(4):527-543. doi: 
      10.1016/j.jmir.2021.08.013. Epub 2021 Sep 24.