-DIBH radiotherapy was characterized by excellent patient compliance and high set-up accuracy which was non-inferior to the historic FB control. We found that V-DIBH, when compared with FB technique, achieved significant reduction of all analyzed DVH parameters for LAD and heart ( Table 2 ). In our patient cohort, the mean cardiac dose was reduced by 50% and V25Gy by 64% ( Table 2 ). The heart-sparing effect afforded by the V-DIBH did not come at a cost of inferior dose-coverage of the OPTV when compared with the FB treatment plans ( Table 2 ). Covariates that impact the cardiac
Noora Al-Hammadi, Palmira Caparrotti, Carole Naim, Jillian Hayes, Katherine Rebecca Benson, Ana Vasic, Hissa Al-Abdulla, Rabih Hammoud, Saju Divakar and Primoz Petric
Qian Zhang, Xiao Li Yu, Wei Gang Hu, Jia Yi Chen, Jia Zhou Wang, Jin Song Ye and Xiao Mao Guo
Background. The aim of the study was to evaluate the dosimetric benefit of applying volumetric modulated arc therapy (VMAT) on the post-mastectomy left-sided breast cancer patients, with the involvement of internal mammary nodes (IMN).
Patients and methods. The prescription dose was 50 Gy delivered in 25 fractions, and the clinical target volume included the left chest wall (CW) and IMN. VMAT plans were created and compared with intensity-modulated radiotherapy (IMRT) plans on Pinnacle treatment planning system. Comparative endpoints were dose homogeneity within planning target volume (PTV), target dose coverage, doses to the critical structures including heart, lungs and the contralateral breast, number of monitor units and treatment delivery time.
Results. VMAT and IMRT plans showed similar PTV dose homogeneity, but, VMAT provided a better dose coverage for IMN than IMRT (p = 0.017). The mean dose (Gy), V30 (%) and V10 (%) for the heart were 13.5 ± 5.0 Gy, 9.9% ± 5.9% and 50.2% ± 29.0% by VMAT, and 14.0 ± 5.4 Gy, 10.6% ± 5.8% and 55.7% ± 29.6% by IMRT, respectively. The left lung mean dose (Gy), V20 (%), V10 (%) and the right lung V5 (%) were significantly reduced from 14.1 ± 2.3 Gy, 24.2% ± 5.9%, 42.4% ± 11.9% and 41.2% ± 12.3% with IMRT to 12.8 ± 1.9 Gy, 21.0% ± 3.8%, 37.1% ± 8.4% and 32.1% ± 18.2% with VMAT, respectively. The mean dose to the contralateral breast was 1.7 ± 1.2 Gy with VMAT and 2.3 ± 1.6 Gy with IMRT. Finally, VMAT reduced the number of monitor units by 24% and the treatment time by 53%, as compared to IMRT.
Conclusions. Compared to 5-be am step-and-shot IMRT, VMAT achieves similar or superior target coverage and a better normal tissue sparing, with fewer monitor units and shorter delivery time.
M. Kozarski, P. Suwalski, K. Zieliński, K. Górczyńska, B. Szafron, K.J. Pałko, R. Smoczyński and M. Darowski
R eferences  R.O. Bonow, B.A. Carabello, K. Chatterjee, A.C. de Leon, D.P. Faxon, M.D. Freed, W.H. Gaasch, B.W. Lytle, R.A. Nishimura, P.T. O’Gara, R.A. O’Rurke, C.M. Otto, P.H. Shah, and I.S. Shanewise, “2006 writing committee members. American college of cardiology/american heart association task force 2008 focused update incorporated into the acc/aha 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association. Task force on practice guideline (writing committee
Yi Chih Chang, Tien Hsing Chen, Pyng Jing Lin, Kuo Chun Hung, Fen Chiung Lin, Chun Chieh Wang, I Chang Hsieh, Jian Liang Wang, Hung Ta Wo and Chien Chia Wu
References 1. Wu ZK, Sun PW, Zhang FT, Tong CW, Lu K. Superiority of mitral valve replacement with preservation of subvalvular structure to conventional replacement in severe rheumatic mitral valve disease: A modified technique and results of one-year follow up. J Heart Valve Dis. 2000; 9:616-22. 2. Athanasiou T, Chow A, Rao C, Aziz O, Siannis F, Ali A, et al. Preservation of the mitral valve apparatus: evidence synthesis and critical reappraisal of surgical techniques. Eur J Cardiothorac Surg. 2008; 33
Ionela Movileanu, Marius Harpa, Klara Branzaniuc, Horatiu Suciu, Ovidiu S. Cotoi, Peter Olah and Dan Simionescu
, Shi W, et al - Surface heparin treatment of the decellularized porcine heart valve: Effect on tissue calcification. J Biomed Mater Res B Appl Biomater. 2017 Feb;105(2):231–466. 12. Korossis SA, Wilcox HE, Watterson KG, et al - In-vitro assessment of the functional performance of the decellularized intact porcine aortic root. J Heart Valve Dis. 2005 May;14(3):408-21. 13. de Kerchove L, Jashari R., Boodhwani M, et al - Surgical anatomy of the aortic root: implication for valve sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surg
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Unlike 2D radiotherapy, 3D radiotherapy allows defining the dose delivered to any point to the heart. If radiotherapy is delivered in a breath hold, which allows the heart to move down and posterior to the treatment volume, the sparing effect to the heart is even greater. 32 In a study comparing free breathing (FB) with voluntary deep inspiration breath hold (V-DIBH) resulted in a significant reduction of mean cardiac dose from 6.1 +/- 2.5 to 3.2 +/- 1.4 Gy (p < 0.001), maximum cardiac dose from 51.1 +/- 1.4 to 48.5 +/- 6.8 Gy (p = 0.005) and cardiac V25Gy from 8
Saibal Chakravorty, Indranil Purkait, Anil Pareek and Avinash Talware
R eferences 1. Kaplan Y, Ozsarfati J, Nickel C, Koren G. Reproductive outcomes following hydroxychloroquine use for autoimmune diseases: a systematic review and meta-analysis. Br J Clin Pharmacol 81: 835-848, 2016. 2. Sun L, Liu M, Li R et al. Hydroxychloroquine, a promising choice for coronary artery disease? Med Hypotheses 93: 5-7, 2016. 3. Duckworth W, Bennett R, Hamel F. Insulin degradation: progress and potential. Endocr Rev 19: 608-624, 1998. 4. Emami J, Gerstein H, Pasutto F, Jamali F. Insulin-sparing effect of
Gytis Grigaliūnas, Lina Gumbienė, Nomeda Valevičienė, Mindaugas Matačiūnas, Virgilijus Tarutis, Germanas Marinskis and Audrius Aidietis
References  Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39:1890–900.  Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P, et al. Long-term results after early primary repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 2001;122:154–61.  Parry AJ, McElhinney DB, Kung GC, Reddy VM, Brook MM, Hanley FL. Elective primary repair of acyanotic tetralogy of Fallot in early infancy: overall outcome and impact on the pulmonary valve. J Am Coll Cardiol 2000;36:2279–83. [4
Maciej Otto, Jacek Dzwonkowski, Andrzej Januszewicz, Mariola Pęczkowska, Andrzej Kański, Anna Kasperlik-Załuska, Elżbieta Rosłonowska and Jacek Szmidt
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