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  • [In Vivo.] Effects of Radiation Dose on Liver After Free-breathing Volumetric Modulated Arc Therapy for Breast Cancer

    [In Vivo.] Effects of Radiation Dose on Liver After Free-breathing Volumetric Modulated Arc Therapy for Breast Cancer

    한림의대 / 박혜진, 정광호, 구태률*

  • 출처
    In Vivo.
  • 등재일
    2022 Jul-Aug
  • 저널이슈번호
    36(4):1937-1943. doi: 10.21873/invivo.12915.
  • 내용

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    Abstract
    Background/aim: To evaluate the early effect of radiation dose on liver function in breast cancer patients undergoing free-breathing volumetric modulated arc therapy (FB-VMAT).

    Patients and methods: Medical records of 125 patients with breast cancer who underwent curative surgery followed by postoperative radiotherapy using FB-VMAT during 2018-2021 were reviewed. Results of the liver function test (LFT), performed within 1-week before and 6-months after radiotherapy, were collected and compared. The LFTs analyzed albumin, total and direct bilirubin, aspartate transaminase, alanine transferase, and alkaline phosphatase levels. The mean dose and relative liver volume receiving at least 10 Gy, 20 Gy, or 30 Gy were calculated.

    Results: Median follow-up time was 21.4 months. One patient experienced locoregional and distant failures. The mean liver irradiation dose was 325.9 centigray (cGy) for all patients. The liver irradiation dose was higher in patients with right breast cancer than in those with left breast cancer (mean, 434.1 cGy vs. 260.6 cGy, p<0.001). Direct bilirubin and aspartate transaminase levels showed significant differences after FB-VMAT. LFT results outside normal limits were noted in 31 patients at follow-up, but nobody met the criteria of radiation-induced liver disease. Underlying liver disease, breast laterality, systemic treatment, or dose-volume histogram parameters were not associated with abnormal LFT results.

    Conclusion: FB-VMAT can deliver radiation doses safely without adversely affecting the liver. The mean dose ≤4 Gy could be a useful dose criterium of the liver for FB-VMAT plans.

     

     

     

    Affiliations

    Hae Jin Park  1 , Kwang-Ho Cheong  2 , Taeryool Koo  3 , Me Yeon Lee  2 , Kyoung Ju Kim  4 , Soah Park  4 , Taejin Han  5 , Sei-Kwon Kang  5 , Boram Ha  6 , Jai-Woong Yoon  6 , Me Young Kim  7 , Hoonsik Bae  7
    1 Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Republic of Korea.
    2 Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Republic of Korea.
    3 Department of Radiation Oncology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Republic of Korea; kootaeryool@hallym.or.kr.
    4 Department of Radiation Oncology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
    5 Department of Radiation Oncology, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.
    6 Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Republic of Korea.
    7 Department of Radiation Oncology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Gangwon-do, Republic of Korea.

  • 키워드
    Liver toxicity; breast cancer; radiotherapy; volumetric modulated arc therapy.
  • 연구소개
    유방암 환자에게도 세기조절 방사선치료 기법 중 하나인 Volumetric Modulated Arc Therapy (VMAT)을 적용하는 기관이 늘어나고 있습니다. VMAT을 위한 방사선치료 계획을 수립할 때 각종 정상장기에 대하여 허용선량을 설정해야 하는데 기존의 유방암에 대한 VMAT 연구는 폐와 심장 선량에 초점이 맞추어져 있어서 간에 대한 자료는 충분하지 않은 상황입니다. 본 연구가 유방암 VMAT 계획을 수립할 때 참고가 되었으면 합니다.
  • 편집위원

    유방암 VMAT 치료 시 간에 대한 선량체적제한치를 제시함

    2022-08-25 13:48:44

  • 편집위원

    유방암치료시 간에 조사되는 저선량에서는 방사선유발 간독성이 발생하지 않음을 보여주는 연구입니다.

    2022-08-31 16:54:02

  • 편집위원2

    본 연구는 자유-호흡 회전방사선치료를 받는 유방암 환자에서 방사선 선량에 따른 간 영향에 관해 평가한 연구이다. 해당 치료를 받은 유방암 환자 125명을 평가하여 4 Gy 이하의 선량은 간에 악영향을 미치지 않음을 확인했다.

    2022-09-05 14:34:17

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