Dose to the cardiac vascular and conduction systems in primary breast irradiation

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists
N A JanjanJ F Wilson

Abstract

Using computerized tomography (CT) in which cardiac anatomy was defined, doses delivered to the cardiac compartments, vascular and conduction systems were assessed for various standard techniques of primary breast irradiation. Included in the analysis were 6 MV photon tangents (T) alone, or in conjunction with a separate internal mammary field (IMF). Beams evaluated in the IMF were 6 MV photons, 12 MeV electron beam, and mixed photon/electron beam; Cobalt 60 was also analyzed as an alternate photon beam. Treatment of the IMF with photons, either alone or in combination with electron beam, delivered doses ranging between 30 Gy to 50 Gy to all chambers of the heart, coronary arteries and branches of the conduction system. Complete sparing of the posterior cardiac structures and volume is accomplished with treatment plans using tangents alone or in combination with 12 MeV electron beam irradiation to the IMF. Sparing of the anterior wall of the left ventricle, Bundle of His and left anterior descending coronary artery is also achieved in treatment with tangents and 12 MeV electron beam IMF. Doses to this region with tangents alone ranged from 20 Gy to 45 Gy compared to 0 to 30 Gy with tangents and 12 MeV electron beam IMF. Clinica...Continue Reading

Citations

Mar 11, 2004·The British Journal of Radiology·K VenablesP J Hoskin
Apr 17, 2013·Breast Cancer : Basic and Clinical Research·Safora JohansenSophie D Fosså
Jul 26, 2018·The British Journal of Radiology·Yoshihiro UedaIndra J Das
Mar 7, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·A RechtUNKNOWN American Society of Clinical Oncology
Nov 26, 2015·Nature Reviews. Clinical Oncology·Timothy M ZagarLawrence B Marks
Feb 19, 2009·Journal of Applied Clinical Medical Physics·Ashley A GaleMichael G Heckman
Jul 20, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Candace R CorreaEleanor E Harris

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