Why the study?
Incidental radiation to the heart during adjuvant breast cancer radiotherapy increases the risk of cardiac disease and mortality, prompting the need to summarize heart-sparing techniques such as deep inspiration breath hold.
Does deep inspiration breath hold reduce incidental cardiac radiation exposure in breast cancer patients receiving adjuvant radiotherapy?
Does deep inspiration breath hold reduce incidental cardiac radiation exposure in breast cancer patients receiving adjuvant radiotherapy?
Deep inspiration breath hold is a non-invasive technique that significantly reduces incidental radiation exposure to the heart and LAD during breast cancer radiotherapy, potentially lowering the risk of radiation-induced cardiac toxicity.
Incidental cardiac radiation exposure warrants heart-sparing techniques in left-sided breast cancer; leaves open precise safe dose thresholds.
Adjuvant radiation therapy is a critical component of breast cancer management. However, when breast cancer patients receive incidental radiation to the heart, there is an increased risk of cardiac disease and mortality. This is most common for patients with left-sided breast cancers and those receiving nodal irradiation as part of treatment. The overall risk of cardiac toxicity increases 4-16% with each Gray increase in mean heart radiation dose, with data suggesting that no lower limit exists which would eliminate cardiac risk entirely. Radiation techniques have improved over time, leading to lower cardiac radiation exposure than in the past. This decline is expected to reduce the incidence of radiation-induced heart dysfunction in patients. Deep inspiration breath hold (DIBH) is one such technique that was developed to reduce the risk of cardiac death and coronary events. DIBH is a non-invasive approach that capitalizes on the natural physiology of the respiratory cycle to increase the distance between the heart and the therapeutic target throughout the course of radiation therapy. DIBH has been shown to decrease the mean incidental radiation doses to the heart and left anterior descending coronary artery by approximately 20-70%. In this review, we summarize different techniques for DIBH and discuss recent data on this technique.
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Stowe et al. (2022) studied this question.
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