Why the study?
Further investigation of parameters to select which left-sided breast cancer patients will benefit most from the deep inspiration breath-hold technique is essential.
Does the deep inspiration breath-hold (DIBH) technique reduce cardiac and LAD radiation doses compared to free-breathing in patients with left-sided breast cancer?
Does the deep inspiration breath-hold (DIBH) technique reduce cardiac and LAD radiation doses compared to free-breathing in patients with left-sided breast cancer?
Lung volume measurements on CT-simulation scans can help identify which left-sided breast cancer patients will derive the most cardiac-sparing benefit from the deep inspiration breath-hold technique during radiotherapy.
DIBH may lower heart and LAD doses in left-sided BC; leaves open whether routine adoption improves clinical outcomes.
The deep inspiration breath-hold (DIBH) technique has been utilized to reduce the cardiac dose in left-sided breast cancer (BC) patients undergoing radiotherapy. Further investigation of the parameters for selecting which patients will benefit most from DIBH is essential. We performed dosimetric comparisons for 21 patients with left-sided BC who had both computed tomography (CT)-based free-breathing (FB) and DIBH plans. The doses to the heart and left anterior descending artery (LAD) and any reduction due to the DIBH technique were analysed. Based on CTFB plans, dosimetric analysis revealed that the irradiation doses to the heart and LAD were significantly correlated with the target volume, the ipsilateral lung volume (ILV) and the total lung volume (TLV). When patients had an ILV ≥ 950 cm3 or a TLV ≥ 2200 cm3, the irradiation doses to the heart and LAD were significantly decreased. Furthermore, the reduction in the mean heart dose (MHD) was correlated to the difference in lung volume between FB and DIBH. The difference in ILV between DIBH and FB of 1.8 indicated that the patients obtained more benefit from the DIBH technique. The data suggest that lung volume (ILV and TLV) measured on a CT-simulation scan and the difference between FB and DIBH could be utilized to help select patients for DIBH.
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Chang et al. (2020) studied this question.
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