Unveiling regions associated with acute and late breast side-effects from breast radiotherapy using voxel-wise image-based data mining analysis

Jaikuna T.; Wilson F.; Anandadas C.; Azria D.; Chang-Claude J.; De Santis M.C.; Gutiérrez-Enríquez S.; van Herk M.; Hoskin P.; Kotzki L.; Lambrecht M.; Lingard Z.; Seibold P.; Seoane A.; Sperk E.; Symonds R.P.; Talbot C.J.; Rancati T.; Rattay T.; Reyes V.; Rosenstein B.S.; de Ruysscher D.; Vega A.; Veldeman L.; Webb A.; West C.M.; Vasquez Osorio E.; Aznar M.C.

Unveiling regions associated with acute and late breast side-effects from breast radiotherapy using voxel-wise image-based data mining analysis

5

Issued Date

2026-01-01

Resource Type

Article

ISSN

01678140

eISSN

18790887

DOI

10.1016/j.radonc.2025.111230

Scopus ID

2-s2.0-105020060415

Pubmed ID

41429725

Journal Title

Radiotherapy and Oncology

Volume

214

Rights Holder(s)

SCOPUS

Bibliographic Citation

Radiotherapy and Oncology Vol.214 (2026)

Suggested Citation

Jaikuna T., Wilson F., Anandadas C., Azria D., Chang-Claude J., De Santis M.C., Gutiérrez-Enríquez S., van Herk M., Hoskin P., Kotzki L., Lambrecht M., Lingard Z., Seibold P., Seoane A., Sperk E., Symonds R.P., Talbot C.J., Rancati T., Rattay T., Reyes V., Rosenstein B.S., de Ruysscher D., Vega A., Veldeman L., Webb A., West C.M., Vasquez Osorio E., Aznar M.C. Unveiling regions associated with acute and late breast side-effects from breast radiotherapy using voxel-wise image-based data mining analysis. Radiotherapy and Oncology Vol.214 (2026). doi:10.1016/j.radonc.2025.111230 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114583

Title

Unveiling regions associated with acute and late breast side-effects from breast radiotherapy using voxel-wise image-based data mining analysis

Corresponding Author(s)

Jaikuna T.

Other Contributor(s)

Mahidol University

Abstract

Background and purpose: Side-effects after breast cancer treatment, including radiotherapy (RT), can drastically affect a patient's quality of life. This study aims to identify anatomical regions where RT dose is related to breast side-effects using the voxel-wise image-based data mining (IBDM) technique. Materials and Methods: Data of 922 patients included in the REQUITE study and who underwent RT after breast-conserving surgery were analysed. All patients were treated supine. We analysed breast pain, oedema, atrophy, induration, and nipple retraction, scored before and after RT by clinicians and patients. We investigated the toxicity burden using the area under the curve for toxicity over time (ToxT-AUC) and applied IBDM by normalising all dose distributions to three reference anatomies. To do so, we established a spatial normalisation pipeline, ensuring that the ipsilateral breast was aligned (flipping all left-side treatments laterally). Dose distributions were converted to equivalent dose in 2 Gy-fraction (EQD<inf>2</inf>, α/β = 1.7 Gy and 3 Gy) to account for different RT fractionations. To determine the relevance of each identified region, we used multivariable ordinal regression, including patient-specific factors and clinical variables. Results: Significant regions associated with each breast side-effect were found in different breast quadrants. The regions showed higher mean EQD<inf>2</inf> than the complete breast contour, particularly for grade 2+ (p < 0.01). Dosimetric parameters extracted from the region were significant in multivariable analysis. Conclusion: We found regions within the breast where the local dose associates with breast side-effects after breast RT. This result opens a new hypothesis which could help reduce side-effects after breast radiotherapy.

Keyword(s)

Medicine

URI

https://repository.li.mahidol.ac.th/handle/123456789/114583

Collections

Scopus 2026

Full item page

Send Feedback