Reduced increase of calcium scores using breath-hold in left-sided whole breast irradiation

• Published in: Radiotherapy and oncology 2020-08, Vol.149, p.78-83
• Main Authors: Mast, M.E., Pekelharing, J.F., Heijenbrok, M.W., van Klaveren, D., van Kempen-Harteveld, M.L., Petoukhova, A.L., Verbeek-de Kanter, A., Schreur, J.H.M., Struikmans, H.
• Format: Article
• Language: English
• Subjects: Breast cancer; Breast Neoplasms - radiotherapy; Breath Holding; Calcium; Coronary arteries; Coronary artery calcium scores; Heart; Humans; Longitudinal Studies; Prospective Studies; Radiotherapy Dosage
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2020.05.001

•We found a significant attenuation of calcium scores in time using breath-hold.•This effect was even higher in patients with calcium scores > 0 at baseline.•This effect became more pronounced after longer follow-up. In this prospective longitudinal study, Coronary Artery Calcium (CAC) scores determined before the start of whole breast irradiation were compared with those determined 7 years afterwards. The aim was to examine whether the use of a breath-hold (BH) technique is associated with less increase of CAC scores. Changes in CAC scores were analysed in 87 breast cancer patients. The results of the following groups were compared: patients receiving right (R) or left-sided radiotherapy using free breathing (L-FB) with those receiving left-sided radiotherapy with BH (L-BH). We compared the changes of CAC scores between these groups over time, testing the hypothesis that a significantly reduced increase of calcium scores is observed when using BH. For L-BH cases, when compared with L-FB cases, for overall as well as for Left Anterior Descending coronary artery (LAD) CAC scores, we noted significantly less increased CAC scores (p 0 at baseline. The attenuated increase over time of CAC scores in the L-BH group was robust to correction for age and statin use (p