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KEY WORDS cardiac toxicity, cardiotoxicity, non–small cell lung cancer, NSCLC, radiotherapy
APPENDIX For supplemental tables and figures, please see the online version of this DL-Homocysteine paper. Practical Radiation Oncology (2019) 9, 158-171
Basic Original Report
Cardiac Structure Doses in Women Irradiated for Breast Cancer in the Past and Their Use in Epidemiological Studies
Frances K. Duane FFR RCSI, DPhil a,*, Paul McGale PhD b, Dorthe Brønnum MSc c, David J. Cutter FRCR, DPhil b,
Sarah C. Darby PhD b, Marianne Ewertz DM, Sc d, Sara Hackett PhD e, Per Hall PhD f,g, Ebbe L. Lorenzen PhD h, Kazem Rahimi DM i,
Zhe Wang PhD a, Samantha Warren PhD j, Carolyn W. Taylor FRCR, DPhil b
aMedical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom; bClinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom; cCentre for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, Hjørring, Denmark; dDepartment of Oncology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Denmark; eCRUK/MRC Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, United Kingdom; fDepartment of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; gDepartment of Oncology, South General Hospital, Stockholm, Sweden; hLaboratory of Radiation Physics, Odense University Hospital, Odense, Denmark; iGeorge Institute for Global Health, University of Oxford, Oxford, United Kingdom; and jUniversity of Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Purpose: Incidental cardiac exposure during radiation therapy may cause heart disease. Dose-response relationships for cardiac structures (segments) may show which ones are most sensitive to radiation. Radiation-related cardiac injury can take years to develop; thus, studies need to involve women treated using 2-dimensional planning, with segment doses estimated using a typical computed tomography (CT) scan. We assessed whether such segment doses are accurate enough to use in dose-response relationships using the radiation therapy charts of women with known segment injury. We estimated interregimen and interpatient segment dose variability and segment dose correlations.
Sources of support: This work was funded by a Medical Research Council UK Clinical Research Fellowship grant, and a research contract to the University of Oxford under the Department of Health Policy Research Programme (Studies of Ionising Radiation and the Risk of Heart Disease). Frances K. Duane, Carolyn W. Taylor, and Sarah C. Darby received funding from Cancer Research UK (grant C8225/A21133), the British Heart Foundation Centre for Research Excellence, Oxford (grant RE/13/1/30181), and core funding from Cancer Research UK, the UK Medical Research Council, and the British Heart Foundation to the Oxford University Clinical trial Service Unit (grant MC_U137686858). Samantha Warren received funding from Cancer Research UK (grant C5255/A15935). Kazem Rahimi received funding from National Institute for Health Research, Oxford Biomedical Research Centre, and a National Institute for Health Research Career Development Fellowship. Conflicts of interest: The authors have no conflicts of interest to disclose.