Abstract 52P
Background
Post mastectomy adjuvant radiotherapy (RT) is a critical part in management of breast cancers. Left sided breast cancer cases are at higher risk of developing radiation induced cardiac morbidities. Increased radiation dose to the heart and lung may cause non-breast cancer related mortality and reduce the survival benefits from breast cancer RT. We designed a prospective clinical trial to examine the impact of CPAP on heart and lung during left sided post mastectomy radiotherapy.
Methods
24 left sided post mastectomy patients, after prior consent were included in this study. All patients were simulated in free breathing technique, followed by using CPAP (target pressure 10 to 15 cm of H20). Contouring was done using RTOG guideline. Heart and lung volumes were noted. IMRT virtual plans for both of these techniques were made for all patients using Monaco 5.51.10 software. Mean heart dose, Heart V25, Ipsilateral Lung mean dose, V5, V10, V20 were measured. Mean ± Std values were assessed using Students’ t-test.
Results
Compared to FB, CPAP showed significant difference. Mean heart distance from sternal notch was 6.2 cm and 7.2 cm ;p Value: 0.032 and Mean heart volumes were 354cc and 387cc in the CPAP and FB arms respectively;pValue: 0.665 . Mean left lung volumes were 1281 cc and 1398 cc respectively ;pValue 0.038 favouring CPAP arm. Similarly mean right lung volume of 1552 cc was significantly higher in CPAP arm compared to 1178 cc in FB arm (pValue : 0.041). Heart Dmean was found to be statistically better in CPAP arm (2.5 Gy) compared to FB arm (3.4 Gy) (p Value 0.020). Average V25 of heart was significantly superior in CPAP arm compared to FB arm (0.23% and 2.24% respectively,p Value 0.035). Heart Dmean was 3.1 Gy in CPAP arm compared to 3.7 Gy in FB arm ,pValue: 0.677. Similar result was found for heart V25. CPAP and FB Ipsilateral lung mean dose (6.69Gy and 6.32Gy, pValue: 0.62), Lung V5 (29% and 27.3%, p Value: 0.77), Lung V10 (16.3% and 16.4%, pValue: 0.78), Lung V20 (11.2% and 11.89%, p value 0.22) didn’t show statistical difference.
Conclusions
CPAP is an excellent tool for cardiac sparing in left sided post mastectomy breast cancer cases.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
362P - Efficacy and safety of MCLA-129, an anti-EGFR/c-MET bispecific antibody, in head and neck squamous cell cancer (HNSCC)
Presenter: Irene Braña
Session: Poster Display
Resources:
Abstract
363P - Effect of financial distress and mental well-being of patients with early vs advanced oral cancer on informal caregiver's quality of life: A prospective real-world data from public health sector hospital
Presenter: Abhinav Thaduri
Session: Poster Display
Resources:
Abstract
364P - Artificial intelligence provides more accurately neck lymph nodes auto-segmentation in radiotherapy
Presenter: chiencheh Chen
Session: Poster Display
Resources:
Abstract
365P - Radiotherapy treatment outcomes and treatment compliance of nasopharyngeal cancer patients in Sabah: A retrospective analysis
Presenter: Anbarasan Anbazagan
Session: Poster Display
Resources:
Abstract
366P - Pre-treatment oral fungal microbiome and nasopharyngeal carcinoma prognosis: A population-based cohort study in southern China
Presenter: Yufeng Chen
Session: Poster Display
Resources:
Abstract
367P - Prevalence and association of sarcopenia with mortality in patients with head and neck cancer: A meta-analysis
Presenter: Claire Lim
Session: Poster Display
Resources:
Abstract
368P - Distinct gene expression profiling explored using nanostring tumor signalling 360 panel with validations in different clinical stages of oral submucous fibrosis patients: A first Indian study
Presenter: Yasasve Madhavan
Session: Poster Display
Resources:
Abstract
370P - Low-dose nivolumab with induction chemotherapy for inoperable HNSCC in 111 patients: Response rates, survival, and implications for LMICs
Presenter: Josh Thomas Georgy
Session: Poster Display
Resources:
Abstract
371P - The role of FDG-PET/CT in the assessment of response to radiation therapy in head and neck cancers: A systematic review and meta-analysis
Presenter: Felix Wijovi
Session: Poster Display
Resources:
Abstract
372P - Effectiveness of HAN-MI-RADS (head and neck molecular imaging-reporting and data system) criterion in head and neck squamous cell carcinoma post concurrent chemoradiotherapy
Presenter: Manoj Gupta
Session: Poster Display
Resources:
Abstract