Figure 3.

Evolution of Cancer Radiation Techniques and Impact on Cardiac Dose

Advances in radiation techniques over the last 30 years have significantly decreased the mean heart dose during radiation therapy, especially in breast cancer (top) and lymphoma (bottom). In breast cancer, modern computed tomography (CT) planning and techniques such as deep inspiratory breath hold can help reduce the mean heart dose to <1 Gy. With the changes in systemic therapy and radiation treatment delivery techniques in lymphoma, modern radiation oncology practice has also evolved to reduce the size of historical mantle radiotherapy fields in a risk-adapted fashion to “involved site” or “involved nodal” fields, minimizing dose to surrounding organs while maintaining disease control. (A) Mantle radiotherapy. (B) Involved field radiotherapy. (C) Involved site radiotherapy. 2D = 2-dimensional; 3D = 3-dimensional; 3DCRT = 3-dimensional conformal radiation therapy; IMRT = intensity-modulated radiation therapy; RT = radiation therap; VMAT = volumetric modulated arc therapy.