Session Item

Poster Presentation: Anorectal
1200
Poster presentation
World Congress of Brachytherapy 2021
08:00 - 08:40
Which organs should be spared to achieve optimal dose distribution in thoracic tumours?
SP-0007

Abstract

Which organs should be spared to achieve optimal dose distribution in thoracic tumours?
Authors: Muijs|, Christina(1)*[c.t.muijs@umcg.nl];
(1)University Medical Center Groningen- University of Groningen, Radiation Oncology, Groningen, The Netherlands;
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Abstract Text
Abstract text

Radiotherapy might improve the outcome of thoracic tumors. However, this gain is at the expense of radiation induced complication risks, by co-irradiation of several normal tissues, such as heart and lungs. Recent improvements in photon techniques, like IMRT/VMAT and the use of breath hold, resulted in reductions of high dose regions in heart or lungs, which seems to decrease the risk of non-cancer related deaths. Proton beam radiotherapy reduces the dose to both heart and lungs substantially, especially low dose areas. The introduction of these new radiotherapy techniques, enabling accurate dose modification, raises the question how to prioritize these organs at risk. Historically, radiation oncologists focused on reducing lung dose to reduce the risk of radiation pneumonitis. However, recently also a wide spectrum of cardiac complications (coronary events, heart failure, arrhythmia) and even cardiac death were observed1. Both cardiac and pulmonary radiation induced complication are related to overall survival2. Moreover, the question of how to prioritize and/or reduce the combined risk of these toxicities is complicated by the interaction between heart and lungs. In summary, in the treatment of thoracic tumours both pulmonary as well as cardiac complication risks should be minimized. Proton radiotherapy reduces the radiation dose to both organs at risk.  

References
Lin SH, Zhang N, Godby J et al. Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer. Cancer. 2016 Mar 15;122(6):917-28
Xu C, Guo L, Liao Z et al. Heart and lung doses are independent predictors of overall survival in esophageal cancer after chemoradiotherapy.Clin Transl Radiat Oncol. 2019 Apr 24;17:17-23.