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http://dx.doi.org/10.3857/jkstro.2010.28.1.23

Probabilities of Pulmonary and Cardiac Complications and Radiographic Parameters in Breast Cancer Radiotherapy  

Noh, O-Kyu (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Park, Sung-Ho (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Ahn, Seung-Do (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Choi, Eun-Kyung (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Lee, Sang-Wook (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Song, Si-Yeol (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Yoon, Sang-Min (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Jong-Hoon (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
Publication Information
Radiation Oncology Journal / v.28, no.1, 2010 , pp. 23-31 More about this Journal
Abstract
Purpose: To evaluate the relationship between the normal tissue complication probability (NTCP) of 3-dimensional (3-D) radiotherapy and the radiographic parameters of 2-dimensional (2-D) radiotherapy such as central lung distance (CLD) and maximal heart distance (MHD). Materials and Methods: We analyzed 110 patients who were treated with postoperative radiotherapy for breast cancer. A two-field tangential technique, a three-field technique, and the reverse hockey stick method were used. The radiation dose administered to whole breast or the chest wall was 50.4 Gy, whereas a 45 Gy was administered to the supraclavicular field. The NTCPs of the heart and lung were calculated by the modified Lyman model and the relative seriality model. Results: For all patients, the NTCPs of radiation-induced pneumonitis and cardiac mortality were 0.5% and 0.7%, respectively. The NTCP of radiation-induced pneumonitis was higher in patients treated with the reverse hockey stick method than in those treated by other two techniques (0.0%, 0.0%, 3.1%, p<0.001). The NTCP of radiation-induced pneumonitis increased with CLD. The NTCP of cardiac mortality increased with MHD ($R^2=0.808$). Conclusion: We found a close correlation between the NTCP of 3-D radiotherapy and 2-D radiographic parameters. Our results are useful to reanalyze the previous 2-D based clinical reports about breast radiation therapy complications as a viewpoint of NTCP.
Keywords
NTCP; Breast cancer radiotherapy; Radiographic parameter; Radiation pneumonitis; Cardiac toxicity;
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