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J Korean Soc Ther Radiol Oncol > Volume 28(1); 2010 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2010;28(1): 23-31. doi: https://doi.org/10.3857/jkstro.2010.28.1.23
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
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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