Basic Treatment Planning

Cardiac Toxicity

Retrospective review of cardiac doses with all techniques. 1997-2001 Denmark & Sweden

Mean heart dose: Denmark1.6-14.9, Sweden 1.2-22.1

Mean heart dose L side 6.6Gy, R side2.9Gy

5-14Gy increases risk cardiac toxicity by 15%; >15Gy increases risk by 108%

3 different manifestations of toxicity 1. Pericarditis . If >30% received 50Gy. Latency 1yr 2. Myocardial damage - lower mean dose. Latency 5yrs 3. IHD . Risk continues to increase 10yrs after RT

Chargari et al. Cardiac Toxicity in Breast Cancer Patients Cancer Treat Rev. 2011 Jun;37(4):321-330. Feng et al. Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cacer. Int J Radiat Oncol Biol Phys. 2011