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Hepatic Irradiation during Modern Radiotherapy Protocols after Breast Conservation [Abstract]

Courtier, Nicholas ORCID:, Gambling, Tina ORCID:, Barrett-Lee, Peter, Abraham, Jincy and Mason, Malcolm David ORCID: 2011. Hepatic Irradiation during Modern Radiotherapy Protocols after Breast Conservation [Abstract]. Clinical Oncology 23 (3) , pp. 199-203. 10.1016/j.clon.2011.01.363

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Introduction The standard - supine with arms abducted to 90o - position for breast radiotherapy is stable, but raises the sub-diaphragmatic organs superiorly. A volume of liver may consequently be included within the radiation portal. The novel aim of this report is to quantify the dose-volume characteristics of hepatic irradiation and to seek relationships with interleukin-6 soluble receptor (IL-6sR), an inflammatory mediator potentially induced by damaged hepatocytes. Methods Participants comprised 98 women with 0–IIa stage breast cancer; undergone breast conservation surgery; prescribed 4000cGy/15 fractions/3 weeks; no prior or concurrent systemic therapies. The liver was outlined on contiguous CT slices and the volume irradiated to 10 and 50% of the dose (Liver10,50) derived via dose-histogram analysis. Enzyme-linked immunosorbent assay kits determined sera concentrations of IL-6sR. Results Liver50 ranged between 0–92 cm3, mean (SD) = 11.7 cm3 (1.1). This was consistent with up to 8% of the liver being irradiated, with a mean of 1.7% and 0.03% for right and left-sided tumours respectively. For right-sided tumours (n = 52), the mean (SD) Liver10 was 56.3 cm3 (52.8). The maximal dose was 113.1% of the prescribed 40Gy, with a mean (SD) value of 87.1% (32.3). A correlation between IL-6sR and Liver10 was non-significant pre-radiotherapy (ρ = .17, p = 0.2), but significant during (ρ = .32, p = 0.02), and four weeks post-radiotherapy (ρ = .38, p = 0.007). No significant correlations were found for left-sided tumours. Conclusions Up to 8% of the liver is irradiated within the primary beam during breast conservation therapy. This volume is insufficient to precipitate radiation-induced liver disease. However, low-dose effects are evident for right-sided treatments, rendering moderate-strength positive associations with IL-6sR. Elevated IL-6sR is associated with fatigue and depression in women with breast cancer. Given the liver’s metabolic role, multi-modal therapy may enhance the findings.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Additional Information: UK Radiation Oncology Conference Abstract 2011
Publisher: Elsevier
ISSN: 0305-7399
Last Modified: 18 Oct 2022 14:04

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