Adding left ventricle and LAD sparing in radiotherapy planning significantly reduces heart and substructure doses (p<0.05) without compromising target coverage in left lung cancer.
Does adding left ventricle and left anterior descending artery sparing to radiotherapy plan optimization improve dosimetric outcomes for the heart in patients with left lung cancer?
Incorporating left ventricle and left anterior descending artery sparing into radiotherapy optimization for left lung cancer significantly reduces radiation dose to these critical cardiac structures without compromising tumor coverage.
Absolute Event Rate: 0% vs 0%
Background: The impact of doses on the left ventricle (LV) and left anterior descending artery (LAD) in relation to major adverse cardiac events is well documented. Studies performed on breast cancer have shown that LV doses are correlated with cardiac toxicity. Materials and Methods: Thirty-two patients with left lung cancer who received radiotherapy at our center were evaluated retrospectively. The left ventricle (LV) and left anterior descending artery (LAD) were contoured as organs at risk on CT simulation images. Seven fields were used in intensity-modulated radiation therapy (IMRT) plans, while two partial arcs were used to create volumetric modulated arc therapy (VMAT) plans. Conventional plans were compared with LV and LAD sparing plans dosimetrically. Results: When comparing conventional plans to sparing plans, no statistically significant differences were found in target volume parameters and values related to critical structures (p>0.05). However, when evaluating the heart (Dmean and V25) and its substructures (LADmean, V15, V30, and LV V5, V10, V15, V30, V40), the plan with LV and LAD sparing demonstrated significantly better outcomes (p<0.05). Conclusion: Therefore, it is essential to contour the substructures of the heart as organs at risk, particularly including LAD and LV in the optimization algorithm during radiotherapy planning for central lung tumors located near the heart.
Diremsizoglu et al. (Sun,) reported a other. Adding left ventricle and LAD sparing in radiotherapy planning significantly reduces heart and substructure doses (p<0.05) without compromising target coverage in left lung cancer.