| Probabilities of Pulmonary and Cardiac Complications and Radiographic Parameters in Breast Cancer Radiotherapy |
| O Kyu Noh, Sung Ho Park, Seung Do Ahn, Eun Kyung Choi, Sang Wook Lee, Si Yeol Song, Sang Min Yoon, Jong Hoon Kim |
| Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sdahn@amc.seoul.kr |
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| 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 (R2=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. |
| Key Words:
NTCP, Breast cancer radiotherapy, Radiographic parameter, Radiation pneumonitis, Cardiac toxicity |
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