EFFECT OF CHANGE IN THE NECK POSITION ON DOSIMETRIC PARAMETERS OF THE OESOPHAGUS IN BREAST CANCER PATIENTS UNDERGOING SUPRACLAVICULAR IRRADIATION

Authors

  • Soma S. Mohammed Amin College of Health & Medical Technology in Sulaimani, Sulaimani Polytechnic University, Kurdistan Region, Iraq.
  • Kharman A. Faraj College of Science, University of Sulaimani, Kurdistan Region, Iraq.

DOI:

https://doi.org/10.17656/jsmc.10431

Keywords:

Oesophagus, dosimetric parameters, breast cancers, neck position, supraclavicular irradiation

Abstract

Background
A limited number of publications examine approaches to decreasing esophageal dose and acute esophagitis during breast cancer radiotherapy (RT).


Objectives
This study aimed to analyze the effect of the two different neck positions when the neck turned to the contralateral side or straight on dosimetric parameters such as mean dose (Dmean) maximum dose (Dmax), and volume of esophagus receiving doses (Vx), in breast patients (BC) who require supraclavicular irradiation.


Materials and Methods
Of all patients undergoing chest wall and supraclavicular regional node irradiation with a dose of 40Gy in 15 fractions, 25 patients were simulated with their necks straight (NS) group, whereas 25 patients with tilted neck position (NT) group. Dmean, Dmax, V5, V10, V15, and V20 were calculated and converted to EQD2 (Equivalent dose in 2 Gy fractions).


Results
Dmean, V5, V10, V15, and V20 were significantly lower in (straight neck position) SN group patients when compared to the (tilted neck position) TN group (P values <0.05). Dmax was slightly higher in the SN group than the NT group (p= 0.083). When the laterality of breast cancer was evaluated in the two groups, all dosimetric parameters (Dmax, Dmean, V5, V10, V15, and V20 ) were higher in left-sided breast cancer as compared in right-sided breast cancer for SN and NT groups (P values <0.05).


Conclusion
We found that the positioning of a straight neck resulted in considerable oesophagal sparing. Therefore, esophagitis may be reduced, which substantially impacts the quality of life of BC survivors.

References

Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A, et al. Regional nodal irradiation in earlystage breast cancer. New England Journal of Medicine. 2015;373(4):307–16.

EBCTCG (Early Breast Cancer Trialists’ Collaborative Group), McGale P, Taylor C, Correa C, Cutter D, Duane F, et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: a meta-analysis of individual patient data

for 8135 women in 22 randomized trials. Lancet. 2014; 383(9935):2127–35.

Early Breast Cancer Trialists' Collaborative Group, Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: a meta-analysis of individual patient data for 10 801 women in 17 randomised trials. The Lancet. 2011; 378(9804),1707-1716.

Taylor C, Correa C, Duane FK, Aznar MC, Anderson SJ, Bergh J, et al. Estimating the risks of breast cancer radiotherapy: Evidence from modern radiation doses to the lungs and heart and from previous randomised trials. Journal of Clinical Oncology. 2017; 35(15):1641–9.

Chaudhry SR, Bordoni B. Anatomy, thorax, oesophagus. Treasure Island (FL): StatPearls Publishing LLC, 2018. https://www.ncbi.nlm.nih.gov/books/NBK482513/2018.

West K, Schneider M, Wright C, Beldham-Collins R, Coburn N, Tiver K, et al. Radiation-induced oesophagitis in breast cancer: Factors influencing onset and severity for patients receiving supraclavicular nodal irradiation. Journal Medical Imaging Radiation Oncology.2020; 64(1):113–9.

Kim TH, Cho KH, Pyo HR, Lee JS, Han JY, Zo JI, et al. Dose-volumetric parameters of acute oesophagal toxicity in patients with lung cancer treated with three-dimensional conformal radiotherapy. International Journal Radiation Oncology Biology Physics. 2005; 62(4):995–1002.

Ahn S-J, Kahn D, Zhou S, Yu X, Hollis D, Shafman TD, et al. Dosimetric and clinical predictors for radiationinduced esophageal injury. International Journal Radiation Oncology Biology. 2005; 61(2):335–47.

Caglar HB, Othus M, Allen AM. Esophagus in-field: a new predictor for esophagitis. Radiotherapy Oncology. 2010: 97(1):48–53.

Dankers R, Troost F. Multivariable normal-tissue complication modelling of acute oesophagal toxicity in advanced stage non-small cell lung cancer patients treated with intensity-modulated (chemo) radiotherapy. Radiotherapy Oncology. 2015; 117(1):49–54.

He J, Yang T. Clinical, dosimetric and position factors for radiation-induced acute esophagitis in intensity-modulated (chemo) radiotherapy for locally advanced non-small-cell lung cancer. Oncology Targets Therapy. 2018; 11:6167–75.

Wang Q, Jie W, Liang Z, Wu H, Cheng J. Postmastectomy intensity modulation radiated therapy of chest wall and regional nodes: Retrospective analysis of the performance and complications up for five years. Medicine (Baltimore). 2017; 96(39):e7956.

Bhaskaran R, Pulickal SG, Reghu H, Perumangat A, Moolath GB. Comparison of dose volumetric parameters of the oesophagus in the radiation treatment of carcinoma breast with and without oesophagus delineation. Journal Radiotherapy Practical; 2023. 22(e10):1–6, (2023).

Yaney A, Ayan AS, Pan X, Jhawar S, Healy E, Beyer S, et al. Dosimetric parameters associated with radiationinduced esophagitis in breast cancer patients undergoing regional nodal irradiation. Radiotherapy Oncology. 2021; 155:167–73.

Published

2023-12-21

How to Cite

1.
Amin S, Faraj K. EFFECT OF CHANGE IN THE NECK POSITION ON DOSIMETRIC PARAMETERS OF THE OESOPHAGUS IN BREAST CANCER PATIENTS UNDERGOING SUPRACLAVICULAR IRRADIATION. JSMC [Internet]. 2023 Dec. 21 [cited 2024 Jul. 15];13(4):7. Available from: https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10431

Similar Articles

1-10 of 78

You may also start an advanced similarity search for this article.