Jeewon Chon, Peter Laub, Mike Wesolowski, Safi Bajwa, Taylor Drew, Naomi Desai, Nazanin Azarvash, Jennifer S Wick, Timothy King
{"title":"Presence of Tissue Expanders Does Not Affect Radiotherapy Dose Distribution to Heart and Lungs.","authors":"Jeewon Chon, Peter Laub, Mike Wesolowski, Safi Bajwa, Taylor Drew, Naomi Desai, Nazanin Azarvash, Jennifer S Wick, Timothy King","doi":"10.1097/GOX.0000000000006819","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Breast cancer treatment often involves mastectomy and postmastectomy radiotherapy (PMRT). PMRT rates are increasing and can improve outcomes in node-positive cases. Although the risks of PMRT to reconstructed breasts are known, the influence of tissue expanders (TEs) on radiation to nearby organs such as the heart and lungs remains unclear.</p><p><strong>Methods: </strong>Patients who underwent total mastectomy and completed a full course of PMRT with 3-dimensional computer tomography planning between January 2014 and August 2022 at Loyola University Medical Center were included. Patient dose statistics for ipsilateral lung, heart, and clinical target volume, as well as demographics, clinical characteristics, PRMT boost, and bolus were collected. Dose statistics for ipsilateral lung and heart were compared between mastectomy versus mastectomy + TE, and dose statistics were compared between dichotomized TE intraoperative fill volumes. Correlations between dose statistics and BMI were analyzed.</p><p><strong>Results: </strong>A total of 124 patients were included in the study. There were no significant differences in lung or heart radiotherapy across all dose metrics between patients who underwent mastectomy versus mastectomy + TE, or between patients with TE fill volume 60 mL or less versus 60 mL or more. Correlations between BMI and heart maximum dose (<i>P</i> = 0.03) were significantly different and showed a positive, monoclonal correlation (correlation: 0.20, 95% confidence interval: 0.02-0.37).</p><p><strong>Conclusions: </strong>The presence of TE and intraoperative expander fill volume did not affect dose distribution or complications to the organs at risk. Increased BMI correlated with an increased maximum dose to the heart.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6819"},"PeriodicalIF":1.5000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119047/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and Reconstructive Surgery Global Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/GOX.0000000000006819","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Breast cancer treatment often involves mastectomy and postmastectomy radiotherapy (PMRT). PMRT rates are increasing and can improve outcomes in node-positive cases. Although the risks of PMRT to reconstructed breasts are known, the influence of tissue expanders (TEs) on radiation to nearby organs such as the heart and lungs remains unclear.
Methods: Patients who underwent total mastectomy and completed a full course of PMRT with 3-dimensional computer tomography planning between January 2014 and August 2022 at Loyola University Medical Center were included. Patient dose statistics for ipsilateral lung, heart, and clinical target volume, as well as demographics, clinical characteristics, PRMT boost, and bolus were collected. Dose statistics for ipsilateral lung and heart were compared between mastectomy versus mastectomy + TE, and dose statistics were compared between dichotomized TE intraoperative fill volumes. Correlations between dose statistics and BMI were analyzed.
Results: A total of 124 patients were included in the study. There were no significant differences in lung or heart radiotherapy across all dose metrics between patients who underwent mastectomy versus mastectomy + TE, or between patients with TE fill volume 60 mL or less versus 60 mL or more. Correlations between BMI and heart maximum dose (P = 0.03) were significantly different and showed a positive, monoclonal correlation (correlation: 0.20, 95% confidence interval: 0.02-0.37).
Conclusions: The presence of TE and intraoperative expander fill volume did not affect dose distribution or complications to the organs at risk. Increased BMI correlated with an increased maximum dose to the heart.
期刊介绍：
Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
