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

Background 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 ha...

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Bibliographic Details
Published in:Breast cancer (Tokyo, Japan) Japan), 2017, Vol.24 (1), p.86-91
Main Authors: Lin, Angela, Sharieff, Waseem, Juhasz, Janos, Whelan, Tim, Kim, Do-Hoon
Format: Article
Language:English
Subjects:
Breath Holding
Cancer Research
Cardiac patients
Cardiotoxicity - etiology
Comparative analysis
Female
Football (College)
Heart - radiation effects
Humans
Lumpectomy
Mastectomy, Segmental
Medicine
Medicine & Public Health
Oncology
Organs at Risk - radiation effects
Original Article
Radiation
Radiotherapy
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Surgery
Surgical Oncology
Treatment Outcome
Unilateral Breast Neoplasms - radiotherapy
Unilateral Breast Neoplasms - surgery
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Summary:Background 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). Methods 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 
ISSN:1340-6868
1880-4233
DOI:10.1007/s12282-016-0676-5