• Login
    View Item 
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChristieCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsThis CollectionTitleAuthorsIssue DateSubmit DateSubjects

    My Account

    LoginRegister

    Local Links

    The Christie WebsiteChristie Library and Knowledge Service

    Statistics

    Display statistics

    Cardiac exposure in lung cancer radiotherapy: systematic review of heart doses published 2013-2020

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Authors
    Kearney, M.
    Keys, Maeve
    Faivre-Finn, Corinne
    Wang, Z.
    Aznar, Marianne Camille
    Duane, F.
    Affiliation
    Applied Radiation Therapy Trinity, Trinity College Dublin, Dublin, Ireland
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Purpose or Objective Lung cancer radiotherapy increases the risk of acute and late cardiotoxicity. Increased radiation dose to the heart has been associated with poorer survival. This study aims to describe heart radiation doses exposure from lung cancer radiotherapy and to summarise the treatment strategies in the modern era leading to a reduction in such exposure. Materials and Methods A systematic review of studies reporting heart radiation doses published between 2013-2020 was undertaken. Doses were compared according to laterality, region irradiated, treatment modality (stereotactic ablative body radiotherapy (SABR) or non-SABR), radiation modality (photon beam therapy or particle beam therapy), and use of respiratory motion management. Dose optimisation objectives and dose volume constraints (DVCs) for the heart were extracted for intensity modulated radiotherapy and particle therapy regimens to determine the priority placed on the heart in inverse planning optimisation. Results The average mean whole heart dose (MHD) across 560 regimens in 140 studies was 8.4 Gy (range 0.1-48.4). Average exposure was not significantly different between left and right-sided tumours. For 392 non-SABR regimens in 105 studies, the average MHD was 10.3 Gy (range 0-48.4). MHD was similar in the IMRT and 3DCRT groups (10.9 Gy versus 10.6 Gy) and lower in the particle therapy group (proton 7.0 Gy; carbon-ion 1.9 Gy) (Fig 1). MHD was lower in studies using respiratory motion management (7.4 Gy versus 11.4 Gy ) (Fig 2). For non-SAR studies, optimisation dose objectives were described in only 2 studies while heart DVCs were described in only 37% (23/62) of IMRT studies and 21% (3/14) particle therapy studies reporting mean and/or maximum heart dose. The most commonly described DVC was MHD <26 Gy. For 168 SABR regimens in 35 studies, the average MHD was 4.0 Gy (range 0.0-32.4) and lowest for carbon ion SABR regimens (0.5 Gy) (Fig 1). Dose optimisation objectives were described in only 1 study while heart DVCs were described in only 37% (23/62) of IMRT studies and 21% (3/14) particle therapy studies reporting mean and/or maximum heart dose. The dose received by 15cc of the heart was the commonly described DVC with the threshold dose dependant on the dose fractionation. MHD was lower in studies using active (2.4 Gy) compared to non-active (5.0Gy) respiratory motion management techniques. Conclusion In most lung cancer radiotherapy studies the planning priority is rarely placed on the heart. For IMRT, the most common technique used, more stringent planning optimisation objectives for the heart may decrease the delivered dose to the heart. Advanced radiotherapy techniques and technologies including active respiratory motion management or particle based therapy may be considered where cardiac dose is high.
    Citation
    Kearney M, Keys M, Faivre-Finn C, Wang Z, Aznar M, Duane F. Cardiac Exposure in Lung Cancer Radiotherapy: Systematic Review of Heart Doses Published 2013-2020. Radiotherapy and Oncology. 2022 May;170:S331-S3. PubMed PMID: WOS:000806759200330.
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/625485
    Type
    Meetings and Proceedings
    Language
    en
    Collections
    All Christie Publications

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.