Echocardiographic Functional Outcomes Following Regional Nodal Irradiation for Breast Cancer Using Volumetric...

Area of Science:

• Radiation Oncology
• Cardiology
• Medical Physics

Background:

• Regional nodal irradiation (RNI) improves breast cancer outcomes but can increase cardiac radiation dose.
• Volumetric Modulated Arc Therapy (VMAT) offers potential for cardiac dose mitigation but may increase low-dose bath.
• The cardiac implications of VMAT in RNI compared to traditional techniques are not fully understood.

Purpose of the Study:

• To evaluate the early cardiac effects of VMAT-based RNI in breast cancer patients.
• To assess changes in echocardiographic parameters of cardiac function following VMAT-RNI.
• To correlate cardiac radiation dose with functional changes.

Main Methods:

• Prospective enrollment of patients receiving adjuvant RNI with VMAT.
• Echocardiograms performed pre-RT, post-RT, and 6 months post-RT.
• Comparison of echocardiographic parameters (LVEF, GLS) pre- and post-RT, and correlation with heart doses.

Main Results:

• No significant decrement in LVEF or GLS was observed at 6 months post-VMAT RNI.
• Individual patient LVEF and GLS remained stable, with no significant changes.
• No correlation found between mean/max heart dose and changes in LVEF or GLS.

Conclusions:

• VMAT for left-sided RNI did not result in significant early cardiac function decline in this cohort.
• VMAT appears to be a viable strategy for cardiac sparing in patients undergoing RNI.
• Further studies with larger cohorts and longer follow-up are warranted to confirm these findings.