Avoiding the heart : about optimising whole breast irradiation

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Avoiding the heart : about optimising whole breast irradiation

Type: Doctoral Thesis
Title: Avoiding the heart : about optimising whole breast irradiation
Author: Mast, Mirjam Esther
Publisher: Faculty of Medicine / Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2015-06-06
Keywords: Breast cancer
Radiotherapy
Calciumscore
Heart sparing
Breath-hold
IMRT
CT
MR
Abstract: Preclinical and clinical studies reveal that left-sided breast cancer radiotherapy is associated with an increased rate of major coronary events. Consequently, when irradiating women with left-sided breast cancer, specific measures should be taken to decrease the heart dose as much as possible and to avoid radiation-induced coronary artery disease. This thesis focuses on several strategies to optimise the radiation treatment for patients with left-sided breast cancer. With respect to whole breast irradiation we concluded that: • the routine use of MR images in addition to the CT scan, when delineating either the glandular breast tissue or the lumpectomy cavity, does not have added value. • tangential IMRT technique combined with a breath-hold technique should be the treatment technique of choice for left-sided breast cancer. • a breath-hold technique should and can be used in all left-sided breast cancer patients, regardless of age and breast size. • breath-hold in left-sided whole breast radiotherapy results in a less pronounced increase of coronary calcium score and, hence, could result in less radiation-induced cardio vascular damage.
Description: Promotor: H. Struikmans, Co-promotores: A.L. Petoukhova, A.N. Scholten
With summary in Dutch
Faculty: LUMC
Citation: Mast, M.E., 2015, Doctoral Thesis, Leiden University
ISBN: 9789082241518
Handle: http://hdl.handle.net/1887/32932
 

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application/pdf General Introduction 197.7Kb View/Open
application/pdf Chapter 1 3.873Mb View/Open
application/pdf Chapter 2 4.409Mb View/Open
application/pdf Chapter 3 646.5Kb View/Open
application/pdf General discussion 1.001Mb View/Open
application/pdf Summary 111.1Kb View/Open
application/pdf Summary in Dutch 101.4Kb View/Open
application/pdf Appendices Abbr ... um Vitae_Acknowledgements 602.1Kb View/Open
application/pdf Propositions 79.90Kb View/Open

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