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Tangential Field Radiotherapy for Breast Cancer—The Dose to the Heart and Heart Subvolumes: What Structures Must Be Contoured in Future Clinical Trials?

Overview of attention for article published in Frontiers in oncology, June 2017
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (64th percentile)
  • Good Attention Score compared to outputs of the same age and source (73rd percentile)

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6 X users

Citations

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28 Dimensions

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34 Mendeley
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Title
Tangential Field Radiotherapy for Breast Cancer—The Dose to the Heart and Heart Subvolumes: What Structures Must Be Contoured in Future Clinical Trials?
Published in
Frontiers in oncology, June 2017
DOI 10.3389/fonc.2017.00130
Pubmed ID
Authors

Marciana Nona Duma, Anne-Claire Herr, Kai Joachim Borm, Klaus Rüdiger Trott, Michael Molls, Markus Oechsner, Stephanie Elisabeth Combs

Abstract

The aim of the present study was to evaluate if it is feasible for experienced radiation oncologists to visually sort out patients with a large dose to the heart. This would facilitate large retrospective data evaluations. And in case of an insufficient visual assessment, to define which structures should be contoured and which structures can be skipped as their dose can be derived from other easily contoured structures for future clinical trials. Planning CTs of left-sided breast cancer patients treated with 3D-conformal radiotherapy by tangential fields were visually divided into two groups: with an estimated high dose (HiD) and with an estimated low dose (LoD) to the heart. For 46 patients (22 HiD and 24 LoD), the heart, the left ventricle, the left anterior descending artery (LAD), the right coronary artery, and the ramus circumflexus were contoured. A helper structure (HS) around the LAD was generated in order to consider if contouring uncertainties of the LAD could be acceptable. We analyzed the mean dose (Dmean), the maximum dose, the V10, V20, V30, V40, and the length of the LAD that received 20 and 40 Gy. The two groups had a significant different Dmean of the heart (p < 0.001). The average Dmean to the heart was 4.0 ± 1.3 Gy (HiD) and 2.3 ± 0.8 Gy (LoD). The average Dmean to the LAD was 26.2 ± 7.4 Gy (HiD) and 13.0 ± 7.5Gy (LoD) with a very strong positive correlation between Dmean LAD and Dmean HS in both groups. The Dmean heart is not a good surrogate parameter for the dose to the LAD since it might underestimate clinically significant doses in 1/3 of the patients in LoD group. A visual assessment of the dose to the heart could be reliable if performed by experienced radiation oncologists. However, the Dmean heart is not always a good surrogate parameter for the dose to the LAD or for the Dmean to the left ventricle. Thus, if specific late toxicities are evaluated, we strongly recommend contouring of the specific heart substructures as a heart Dmean is not highly specific.

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X Demographics

The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 24%
Other 5 15%
Student > Master 3 9%
Student > Bachelor 2 6%
Professor 2 6%
Other 7 21%
Unknown 7 21%
Readers by discipline Count As %
Medicine and Dentistry 13 38%
Biochemistry, Genetics and Molecular Biology 3 9%
Nursing and Health Professions 2 6%
Psychology 2 6%
Social Sciences 1 3%
Other 3 9%
Unknown 10 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 July 2017.
All research outputs
#8,128,131
of 26,106,397 outputs
Outputs from Frontiers in oncology
#2,923
of 22,896 outputs
Outputs of similar age
#118,183
of 334,912 outputs
Outputs of similar age from Frontiers in oncology
#21
of 80 outputs
Altmetric has tracked 26,106,397 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 22,896 research outputs from this source. They receive a mean Attention Score of 3.1. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 334,912 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 80 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.