Correlation between gastric volume and organs at risk dose in adjuvant radiotherapy for left breast cancer

The role of the gastric volume on the dose-effect relationship for these organs has not been investigated. The aim of the study was to evaluate the correlation between gastric volume and dose-volume histogram (DVH) parameters of the heart, left lung and stomach during left breast cancer radiotherapy (RT).

Ninety-nine left breast cancer patients who got adjuvant radiotherapy were included. Study was classified into two groups based on treatment field arrangements: 1) breast tangential fields only (T) and 2) breast tangential and supraclavicular fields (TS). Organs DVHs were extracted. Descriptive statistics, Pearson correlation, linear regression analyses, and receiver operating characteristic (ROC) analyses were performed.

There is a direct but not significant correlation between the gastric volume and doses to the stomach and left lung. For a 100-cc increase in the gastric volume, the stomach maximum dose and the V₅₀ increased by 3 Gy and 4%, respectively. For the left lung, V₄ and V₅ increased by 1% for TS cases. Considering ROC analysis results, one can make a decision for about 74% of patients due to their left lung DVH parameters, using gastric volume as a known input data. The correlation between gastric volume and heart dose was not significant.

The gastric volume of about 170 cc or less can result in lower dose to the stomach and ipsilateral lung during left breast cancer radiotherapy, especially for TS cases. To reach this gastric volume threshold, patients should be fast for 2 hours before the procedure of CT simulation and treatment.