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Normal tissue complication probability (NTCP) parameters for breast fibrosis: Pooled results from two randomised trials

Mukesh, MB, Coles, CE, Wilkinson, J, Jena, R, Harris, E, Collette, S, Bartelink, H, Evans, PM, Graham, P, Haviland, J, Poortmans, P and Yarnold, J (2013) Normal tissue complication probability (NTCP) parameters for breast fibrosis: Pooled results from two randomised trials Radiotherapy and Oncology, 108 (2). pp. 293-298.

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Abstract

Introduction The dose-volume effect of radiation therapy on breast tissue is poorly understood. We estimate NTCP parameters for breast fibrosis after external beam radiotherapy. Materials and methods We pooled individual patient data of 5856 patients from 2 trials including whole breast irradiation followed with or without a boost. A two-compartment dose volume histogram model was used with boost volume as the first compartment and the remaining breast volume as second compartment. Results from START-pilot trial (n = 1410) were used to test the predicted models. Results 26.8% patients in the Cambridge trial (5 years) and 20.7% patients in the EORTC trial (10 years) developed moderate-severe breast fibrosis. The best fit NTCP parameters were BEUD(50) = 136.4 Gy, γ50 = 0.9 and n = 0.011 for the Niemierko model and BEUD (50) = 132 Gy, m = 0.35 and n = 0.012 for the Lyman Kutcher Burman model. The observed rates of fibrosis in the START-pilot trial agreed well with the predicted rates. Conclusions This large multi-centre pooled study suggests that the effect of volume parameter is small and the maximum RT dose is the most important parameter to influence breast fibrosis. A small value of volume parameter 'n' does not fit with the hypothesis that breast tissue is a parallel organ. However, this may reflect limitations in our current scoring system of fibrosis. © 2013 Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Divisions : Faculty of Engineering and Physical Sciences > Electronic Engineering > Centre for Vision Speech and Signal Processing
Authors :
AuthorsEmailORCID
Mukesh, MBUNSPECIFIEDUNSPECIFIED
Coles, CEUNSPECIFIEDUNSPECIFIED
Wilkinson, JUNSPECIFIEDUNSPECIFIED
Jena, RUNSPECIFIEDUNSPECIFIED
Harris, EUNSPECIFIEDUNSPECIFIED
Collette, SUNSPECIFIEDUNSPECIFIED
Bartelink, HUNSPECIFIEDUNSPECIFIED
Evans, PMUNSPECIFIEDUNSPECIFIED
Graham, PUNSPECIFIEDUNSPECIFIED
Haviland, JUNSPECIFIEDUNSPECIFIED
Poortmans, PUNSPECIFIEDUNSPECIFIED
Yarnold, JUNSPECIFIEDUNSPECIFIED
Date : August 2013
Identification Number : 10.1016/j.radonc.2013.07.006
Additional Information : NOTICE: this is the author’s version of a work that was accepted for publication in Radiotherapy and Oncology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Radiotherapy and Oncology, 108(2), August 2013, DOI 10.1016/j.radonc.2013.07.006.
Depositing User : Symplectic Elements
Date Deposited : 17 Dec 2014 14:35
Last Modified : 14 Feb 2015 14:33
URI: http://epubs.surrey.ac.uk/id/eprint/806911

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