Beam angle manipulation to reduce cardiac dose during breast radiotherapy

Sindu Vivekanandan, Joyce Mhlanga, D. Launders, A. Przeslak, D. A L Morgan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Standard tangential radiotherapy techniques after breast conservative surgery (BCS) often results in the irradiation of the tip of the left ventricle and the left anterior descending coronary artery (LAD), potentially increasing cardiovascular morbidity. The importance of minimising radiation dose to these structures has attracted increased interest in recent years. We tested a hypothesis that in some cases, by manipulating beam angles and accepting lower-than-prescribed doses of radiation in small parts of the breast distant from the surgical excision site, significant cardiac sparing can be achieved compared with more standard plans. Methods: A sample of 12 consecutive patients undergoing radiotherapy after left-sided BCS was studied. All patients were planned with a 6 MV tangential beam, beam angles were manipulated carefully and if necessary lower doses were given to small parts of the breast distant from the surgical excision site to minimise cardiac irradiation ("institutional" plan). Separate "hypothetical standard" plans were generated for seven patients using set field margins that met published guidelines. Results: In seven patients, the institutional plans resulted in lower doses to the LAD and myocardium than the hypothetical standard plans. In the other five patients, LAD and myocardial doses were deemed minimal using the hypothetical standard plan, which in these patients corresponded to the institutional plan (the patients were actually treated using the institutional plans). Conclusion: Much attention has been devoted to ways of minimising cardiac radiation dose. This small sample demonstrates that careful manipulation of beam angles can often be a simple, but effective technique to achieve this.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalBritish Journal of Radiology
Volume85
Issue number1011
DOIs
StatePublished - Mar 2012
Externally publishedYes

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Breast
Radiotherapy
Radiation
Heart Ventricles
Coronary Vessels
Myocardium
Guidelines
Morbidity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Vivekanandan, S., Mhlanga, J., Launders, D., Przeslak, A., & Morgan, D. A. L. (2012). Beam angle manipulation to reduce cardiac dose during breast radiotherapy. British Journal of Radiology, 85(1011), 265-271. https://doi.org/10.1259/bjr/58636261

Beam angle manipulation to reduce cardiac dose during breast radiotherapy. / Vivekanandan, Sindu; Mhlanga, Joyce; Launders, D.; Przeslak, A.; Morgan, D. A L.

In: British Journal of Radiology, Vol. 85, No. 1011, 03.2012, p. 265-271.

Research output: Contribution to journalArticle

Vivekanandan, S, Mhlanga, J, Launders, D, Przeslak, A & Morgan, DAL 2012, 'Beam angle manipulation to reduce cardiac dose during breast radiotherapy', British Journal of Radiology, vol. 85, no. 1011, pp. 265-271. https://doi.org/10.1259/bjr/58636261
Vivekanandan S, Mhlanga J, Launders D, Przeslak A, Morgan DAL. Beam angle manipulation to reduce cardiac dose during breast radiotherapy. British Journal of Radiology. 2012 Mar;85(1011):265-271. https://doi.org/10.1259/bjr/58636261
Vivekanandan, Sindu ; Mhlanga, Joyce ; Launders, D. ; Przeslak, A. ; Morgan, D. A L. / Beam angle manipulation to reduce cardiac dose during breast radiotherapy. In: British Journal of Radiology. 2012 ; Vol. 85, No. 1011. pp. 265-271.
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