Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Diagnostic Work-Up and Follow-Up Courses
2.3. FDG PET/CT
2.4. Adjuvant RT
2.5. Image Analysis
2.6. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Comparison of Myocardial FDG Uptake between Left and Right Breast Cancers
3.3. Comparison of the Irradiated Myocardium-to-Non-Irradiated Myocardium Uptake Ratios between PET Scans
3.4. Comparison of FDG Uptake between the 30 Gy and 47.5 Gy Irradiated Myocardium
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Patients with Left Breast Cancer (n = 55) | Patients with Right Breast Cancer (n = 48) | p-Value | |
---|---|---|---|---|
Age (years) | 51.2 ± 9.9 * | 51.4 ± 9.7 * | 0.928 | |
Menopausal status | Premenopausal | 22 (40.0%) | 17 (35.4%) | 0.634 |
Postmenopausal | 33 (60.0%) | 31 (64.6%) | ||
Histopathology | Intraductal carcinoma | 48 (87.3%) | 41 (85.4%) | 0.785 |
Intralobular carcinoma | 7 (12.7%) | 7 (14.6%) | ||
T stage | T1 | 33 (60.0%) | 35 (72.9%) | 0.191 |
T2 | 19 (34.5%) | 9 (18.8%) | ||
T3 | 3 (5.5%) | 4 (8.3%) | ||
Lymph node metastasis | Absence | 41 (74.5%) | 34 (70.8%) | 0.674 |
Presence | 14 (25.5%) | 14 (29.2%) | ||
Tumor size (cm) | 1.82 ± 1.20 * | 2.09 ± 1.13 * | 0.252 | |
Histologic grade | Grade 1 | 17 (30.9%) | 15 (31.2%) | 0.980 |
Grade 2 | 28 (50.9%) | 25 (52.1%) | ||
Grade 3 | 10 (18.2%) | 8 (16.7%) | ||
Estrogen receptor status | Positive | 49 (89.1%) | 39 (81.2%) | 0.263 |
Negative | 6 (10.9%) | 9 (18.8%) | ||
Progesterone receptor status | Positive | 42 (76.4%) | 30 (62.5%) | 0.128 |
Negative | 13 (23.6%) | 18 (37.5%) | ||
HER2 status | Positive | 27 (49.1%) | 23 (47.9%) | 0.906 |
Negative | 28 (50.9%) | 25 (52.1%) | ||
Triple negative tumor | 2 (3.6%) | 3 (6.2%) | 0.662 | |
Ki67 expression status | Positive (≥14%) | 29 (52.7%) | 27 (56.2%) | 0.722 |
Negative (<14%) | 26 (47.3%) | 21 (43.7%) | ||
Hypertension | Yes | 8 (14.5%) | 11 (22.9%) | 0.277 |
No | 47 (85.5%) | 37 (77.1%) | ||
Diabetes mellitus | Yes | 8 (14.5%) | 9 (18.8%) | 0.568 |
No | 47 (85.5%) | 39 (81.2%) | ||
Dyslipidemia medication | Yes | 2 (3.6%) | 3 (6.3%) | 0.540 |
No | 53 (96.4%) | 45 (93.7%) | ||
Serum total cholesterol level on staging blood tests | 187 ± 29 * | 194 ± 35 * | 0.340 | |
Serum triglyceride level on staging blood tests | 143 ± 95 * | 134 ± 103 * | 0.662 | |
Adjuvant treatment | CTx+RT+Hx | 37 (67.3%) | 26 (54.2%) | 0.322 |
RT+Hx | 17 (30.9%) | 18 (37.5%) | ||
CTx+RT | 1 (1.8%) | 3 (6.2%) | ||
RT alone | 0 (0.0%) | 1 (2.1%) | ||
Chemotherapy regimen | AC | 14 (25.5%) | 9 (18.8%) | 0.551 |
TAC | 11 (20.0%) | 12 (25.0%) | ||
CMF | 8 (14.5%) | 7 (14.6%) | ||
FAC | 3 (5.5%) | 1 (2.1%) | ||
FEC | 2 (3.6%) | 0 (0.0%) | ||
Prescribed total radiation dose (Gy) | Whole breast RT dose | Median, 50.4 (range, 50–50.4) | Median, 50.4 (range, 45–50.4) | 0.440 |
Boost RT dose | Median, 16 (range, 8–16) | Median, 16 (range, 10–16) | 0.225 | |
Boost RT location | UOQ | 24 (49%) | 24 (57.1%) | 0.077 |
UIQ | 11 (22.4%) | 10 (23.8%) | ||
LOQ | 4 (8.2%) | 6 (14.3%) | ||
LIQ | 4 (8.2%) | 2 (4.8%) | ||
Central | 6 (12.2%) | 0 (0%) | ||
Interval between CTx and PET2 (days) | 11.9 ± 4.6 * | 13.5 ± 6.3 * | 0.322 | |
Interval between RT and PET3 (days) | 139.7 ± 28.1 * | 132.0 ± 28.2 * | 0.170 | |
Interval between RT and PET4 (days) | 357.4 ± 50.2 * | 363.6 ± 49.3 * | 0.605 |
Patients | Myocardium-to-Blood Pool Uptake Ratio | |||
---|---|---|---|---|
PET1 | PET2 | PET3 | PET4 | |
Patients with left breast cancer | 1.33 ± 1.10 | 1.54 ± 1.07 | 1.41 ± 0.92 | 1.47 ± 1.00 |
Patients with right breast cancer | 1.26 ± 0.59 | 1.61 ± 1.16 | 1.47 ± 1.16 | 1.43 ± 0.89 |
p-values | 0.318 | 0.357 | 0.695 | 0.869 |
Variables | PET1 (n = 55) | PET2 (n = 29) | PET3 (n = 55) | PET4 (n = 37) |
---|---|---|---|---|
30 Gy uptake ratio | 0.85 ± 0.12 | 0.84 ± 0.10 | 1.09 ± 0.22 | 1.01 ± 0.18 |
Percent change in the 30 Gy uptake ratio (%) | - | 1.7 ± 11.5 | 28.7 ± 22.3 | 18.2 ± 23.3 |
47.5 Gy uptake ratio | 0.81 ± 0.20 * | 0.83 ± 0.17 † | 1.19 ± 0.28 * | 1.10 ± 0.28 ‡ |
Percent change in the 47.5 Gy uptake ratio (%) | - | 7.0 ± 28.7 † | 50.2 ± 36.9 * | 40.6 ± 51.8 ‡ |
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Jo, I.Y.; Lee, J.W.; Kim, W.C.; Min, C.K.; Kim, E.S.; Yeo, S.-G.; Lee, S.M. Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer. J. Clin. Med. 2020, 9, 666. https://doi.org/10.3390/jcm9030666
Jo IY, Lee JW, Kim WC, Min CK, Kim ES, Yeo S-G, Lee SM. Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer. Journal of Clinical Medicine. 2020; 9(3):666. https://doi.org/10.3390/jcm9030666
Chicago/Turabian StyleJo, In Young, Jeong Won Lee, Woo Chul Kim, Chul Kee Min, Eun Seog Kim, Seung-Gu Yeo, and Sang Mi Lee. 2020. "Relationship between Changes in Myocardial F-18 Fluorodeoxyglucose Uptake and Radiation Dose after Adjuvant Three-Dimensional Conformal Radiotherapy in Patients with Breast Cancer" Journal of Clinical Medicine 9, no. 3: 666. https://doi.org/10.3390/jcm9030666