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Quantifying radiation dose delivered to individual shoulder muscles during breast radiotherapy.

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Title: Quantifying radiation dose delivered to individual shoulder muscles during breast radiotherapy.
Authors: Lipps, David B.1 dlipps@umich.edu, Sachdev, Sean2, Strauss, Jonathan B.2
Source: Radiotherapy & Oncology. Mar2017, Vol. 122 Issue 3, p431-436. 6p.
Subjects: Breast cancer treatment, Cancer radiotherapy, Radiation doses, Treatment effectiveness, Muscle physiology, Computed tomography
Abstract: Background and purpose Radiotherapy is an effective treatment for managing breast cancer, but patients may experience shoulder morbidity after completing radiotherapy. There is a knowledge gap regarding how the inclusion of the regional lymphatics in radiation treatment regimens influence the radiation dose delivered to the underlying shoulder musculature. Material and methods Five standardized radiation treatment regimens were developed from the computed tomography (CT) scans of 11 patients: tangent fields only (T), high tangent fields (HT), T + supraclavicular fossa and axillary apex with an anterior oblique beam (SCV), T + SCV + axillary nodes with an anterior oblique beam (SCV + AX), and T + SCV + AX with the nodal regions treated with a directly opposed beam configuration (DO). The muscle volumes for nine shoulder muscles anatomically located with the treatment regimens were segmented from the same CT scans. The effect of the nine muscles and five treatment regimens on the percentage of each muscle receiving at least 48 Gy (V48 Gy) was analyzed with two-way and one-way repeated measures ANOVAs. Results A statistically significant interaction existed between the nine shoulder muscles and five treatment regimens ( p < 0.001) on the V48 Gy dose. Subsequent one-way analyses found statistically significant main effects of treatment plan on the V48 Gy dose for each muscle ( p < 0.001). The pectoralis major and minor had the greatest V48 doses across the five treatments regimens. The HT, SCV + AX and DO treatment regimens produced statistically significant increases in the V48 dose of the latissimus dorsi and teres major. The infraspinatus, subscapularis, supraspinatus, teres minor, and trapezius only observed statistically significant V48 doses when treated with a DO plan. Conclusions These findings highlight the muscles (pectoralis major, pectoralis minor, latissimus dorsi, and teres major) that may exhibit future morbidity after radiation, and indicate that nodal RT delivered with a DO beam arrangement delivers the highest muscle dose. [ABSTRACT FROM AUTHOR]
Copyright of Radiotherapy & Oncology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
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DbLabel: Engineering Source
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PubType: Academic Journal
PubTypeId: academicJournal
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  Data: Quantifying radiation dose delivered to individual shoulder muscles during breast radiotherapy.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lipps%2C+David+B%2E%22&quot;&gt;Lipps, David B.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; dlipps@umich.edu&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sachdev%2C+Sean%22&quot;&gt;Sachdev, Sean&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Strauss%2C+Jonathan+B%2E%22&quot;&gt;Strauss, Jonathan B.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Radiotherapy+%26+Oncology%22&quot;&gt;Radiotherapy &amp; Oncology&lt;/searchLink&gt;. Mar2017, Vol. 122 Issue 3, p431-436. 6p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Breast+cancer+treatment%22&quot;&gt;Breast cancer treatment&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cancer+radiotherapy%22&quot;&gt;Cancer radiotherapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Radiation+doses%22&quot;&gt;Radiation doses&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Treatment+effectiveness%22&quot;&gt;Treatment effectiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Muscle+physiology%22&quot;&gt;Muscle physiology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Computed+tomography%22&quot;&gt;Computed tomography&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and purpose Radiotherapy is an effective treatment for managing breast cancer, but patients may experience shoulder morbidity after completing radiotherapy. There is a knowledge gap regarding how the inclusion of the regional lymphatics in radiation treatment regimens influence the radiation dose delivered to the underlying shoulder musculature. Material and methods Five standardized radiation treatment regimens were developed from the computed tomography (CT) scans of 11 patients: tangent fields only (T), high tangent fields (HT), T + supraclavicular fossa and axillary apex with an anterior oblique beam (SCV), T + SCV + axillary nodes with an anterior oblique beam (SCV + AX), and T + SCV + AX with the nodal regions treated with a directly opposed beam configuration (DO). The muscle volumes for nine shoulder muscles anatomically located with the treatment regimens were segmented from the same CT scans. The effect of the nine muscles and five treatment regimens on the percentage of each muscle receiving at least 48 Gy (V48 Gy) was analyzed with two-way and one-way repeated measures ANOVAs. Results A statistically significant interaction existed between the nine shoulder muscles and five treatment regimens ( p &lt; 0.001) on the V48 Gy dose. Subsequent one-way analyses found statistically significant main effects of treatment plan on the V48 Gy dose for each muscle ( p &lt; 0.001). The pectoralis major and minor had the greatest V48 doses across the five treatments regimens. The HT, SCV + AX and DO treatment regimens produced statistically significant increases in the V48 dose of the latissimus dorsi and teres major. The infraspinatus, subscapularis, supraspinatus, teres minor, and trapezius only observed statistically significant V48 doses when treated with a DO plan. Conclusions These findings highlight the muscles (pectoralis major, pectoralis minor, latissimus dorsi, and teres major) that may exhibit future morbidity after radiation, and indicate that nodal RT delivered with a DO beam arrangement delivers the highest muscle dose. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Radiotherapy &amp; Oncology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1016/j.radonc.2016.12.032
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 6
        StartPage: 431
    Subjects:
      – SubjectFull: Breast cancer treatment
        Type: general
      – SubjectFull: Cancer radiotherapy
        Type: general
      – SubjectFull: Radiation doses
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Muscle physiology
        Type: general
      – SubjectFull: Computed tomography
        Type: general
    Titles:
      – TitleFull: Quantifying radiation dose delivered to individual shoulder muscles during breast radiotherapy.
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            NameFull: Lipps, David B.
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            NameFull: Sachdev, Sean
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            NameFull: Strauss, Jonathan B.
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              Text: Mar2017
              Type: published
              Y: 2017
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              Value: 122
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