The benefit of deep inspiration breath hold: evaluating cardiac radiation exposure in patients after mastectomy and after breast-conserving surgery

Breast Cancer : the Journal of the Japanese Breast Cancer Society
Angela LinDo-Hoon Kim

Abstract

This study aims to evaluate the reduction of cardiac radiation dose and volume with deep inspiration breath hold (DIBH) technique compared to free breathing (FB) in patients with left-sided breast cancer. The study also aims to evaluate whether the benefits of DIBH vary in patients who had whole breast radiotherapy (RT) after breast-conserving surgery (BCS) and those who had chest wall RT post-mastectomy (M). FB and DIBH plans were generated for 15 consecutive post-BCS patients and 17 post-M patients who underwent RT with DIBH using varian real-time position management (RPM) system. Cardiac shields were used in all post-BCS plans, provided that clinical treatment volume coverage was not compromised, while chest wall coverage took priority in post-M plans. The prescribed dose was 50 Gy in 25 fractions for the whole breast or the chest wall. Parameters of interest were cardiac V5, mean LAD dose, maximum LAD dose, and mean heart dose. The impact of DIBH was compared in post-BCS and post-M patients using paired t tests. To gauge clinically meaningful outcome, the proportion of patients with V5 < 5 % and mean cardiac dose <2 Gy were compared using McNemar's test. DIBH decreased V5 by an absolute 4.5 % (2.3 vs. 6.8 %; p < 0.0001) in ...Continue Reading

References

Mar 31, 1999·International Journal of Radiation Oncology, Biology, Physics·L F PaszatE Holowaty
Jun 6, 2006·International Journal of Radiation Oncology, Biology, Physics·Stine S KorremanHåkan Nyström
Apr 1, 2008·Cancer Control : Journal of the Moffitt Cancer Center·Eleanor E Harris
Nov 19, 2008·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Heidi Stranzl, Brigitte Zurl
Mar 9, 2010·International Journal of Radiation Oncology, Biology, Physics·Gerben R BorstCorine van Vliet-Vroegindeweij
Jun 29, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·D BovelliUNKNOWN ESMO Guidelines Working Group
Nov 26, 2010·International Journal of Radiation Oncology, Biology, Physics·Wei WangAnthony Fyles
Jul 12, 2011·Journal of the National Cancer Institute·Eitan AmirAlberto Ocaña
Dec 4, 2012·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Henrik D Nissen, Ane L Appelt
Mar 15, 2013·The New England Journal of Medicine·Sarah C DarbyPer Hall
Jul 23, 2015·The New England Journal of Medicine·Timothy J WhelanUNKNOWN MA.20 Study Investigators
Jul 23, 2015·The New England Journal of Medicine·Philip M PoortmansUNKNOWN EORTC Radiation Oncology and Breast Cancer Groups

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Citations

Oct 27, 2016·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·S SchöneckerH Scheithauer
Jun 23, 2018·Radiation Oncology·Feng ZhaoSenxiang Yan
Apr 2, 2020·Radiation Oncology Journal·Azam EskandariMehdi Momennezhad
Feb 6, 2020·Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznań and Polish Society of Radiation Oncology·R Soumarová, L Rušinová

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