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Quantification of cardiac dose from breast cancer radiotherapy using computed tomography based dosimetry method

Amina Abdulrahman, Bindu Gopalakrishnan, Binesh P, Ajayakumar T.

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Aim: In breast cancer, chest wall and breast irradiation invariably result in some radiation exposure to the heart and coronary vessels especially in left-sided disease. The purpose of this study is to quantify the dose received by the heart and the Left Anterior Descending artery in left sided breast cancer patients treated in our institution.
Methods and Materials: Patients with breast cancer who had undergone mastectomy or Breast Conservation Surgery and who had indications for post-operative radiotherapy were subjected to a fractionation schedule of 50Gy in 25 fractions to the chest wall or breast using Three Dimensional Conformal Radiotherapy. Dose Volume Histogram for the heart and the Left Anterior Descending artery were generated.
Results: The average mean and maximum dose received by the heart was 14.12 Gy and 53.29 Gy respectively. The average mean and maximum dose received by the Left Anterior Descending artery was 46.6 Gy and 52.5 Gy respectively.
Findings: The mean and maximum dose received by the heart and Left Anterior Descending artery are found to be high in this study. This could be due to differences in target volume delineation and the higher percentage of mastectomy patients in our study. This study highlights the importance of delineating the heart and the Left Anterior Descending artery as organs at risk and the benefit of using cardiac sparing techniques for protecting the heart and coronary vessels.

Key words: Breast Cancer, Radiation, Cardiotoxicity, Heart, LAD

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