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The volume of liver irradiated during modern free-breathing breast radiotherapy: implications for theory and practice

Courtier, Nicholas, Gambling, Tina, Barrett-Lee, Peter, Oliver, Theo and Mason, Malcolm 2019. The volume of liver irradiated during modern free-breathing breast radiotherapy: implications for theory and practice. Radiography 25 (2) , pp. 103-107. 10.1016/j.radi.2018.12.003
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Abstract

Introduction Incidental liver irradiation during breast radiotherapy can increase the risk of second primary malignancy and induce adverse inflammatory states. This study establishes the volume of liver irradiated during free-breathing breast radiotherapy. Novel associations between liver dose-volume data and systemic interleukin-6 soluble receptor and blood counts are evaluated. Methods The volume of liver within the 10%, 50% and 90% isodose was determined for 100 women with stage 0 to II breast carcinoma undergoing 40Gy in 15 fractions over three weeks tangential irradiation. Blood counts and interleukin 6 soluble receptor concentration were recorded before, during and four weeks after radiotherapy. Dose-volume data for right-sided treatments was associated with longitudinal measures at bivariate and multivariable levels. Results A maximum of 226cm3 (19%), 92 cm3 (8%) and 62 cm3 (5%) of the liver was irradiated within the 10%, 50% and 90% isodose. Liver irradiation was almost exclusively a feature of the 52 right-sided treatments and was strongly correlated with breast volume (ρ = 0.7, p < 0.0001). Liver V10% was significantly associated with interleukin-6 soluble receptor concentration four weeks post-radiotherapy (beta = 0.38, p = 0.01) after controlling for theoretical confounding variables. Conclusion Up to 8% of the liver is irradiated within the primary beam during local right-sided breast radiotherapy. Select use of a deep inspiration breath hold technique would reduce this volume, and minimise the risk of radiation-induced malignancy and acute systemic elevation of inflammatory interleukin 6 soluble receptor.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Medicine
Publisher: WB Saunders
ISSN: 1078-8174
Date of First Compliant Deposit: 14 December 2018
Date of Acceptance: 29 November 2018
Last Modified: 03 Jul 2019 09:47
URI: http://orca.cf.ac.uk/id/eprint/117674

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