Key result
Deep inspiration breath hold significantly reduced the minimum dose to 5% of the heart volume (5.26 Gy vs 15.33 Gy) compared to free breathing in left-sided breast cancer patients.
Why the study?
Adjuvant radiotherapy for breast cancer using photon tangential fields carries a risk of late heart and lung toxicity, and the impact of different breathing techniques on irradiated lung and heart volume was evaluated.
Does deep inspiration breath hold (DIBH) reduce irradiated heart volume compared to free breathing and expiration breath hold in women with left-sided breast cancer undergoing adjuvant radiotherapy?
Observational (n=10)
No
Does deep inspiration breath hold (DIBH) reduce irradiated heart volume compared to free breathing and expiration breath hold in women with left-sided breast cancer undergoing adjuvant radiotherapy?
Absolute Event Rate: 5.26% vs 15.33%
p-value: p=0.004
Deep inspiration breath hold significantly reduces the irradiated heart volume during tangential radiotherapy for left-sided breast cancer, potentially lowering the risk of late radiation-induced cardiotoxicity.
DIBH may aid heart sparing in left-sided breast RT; leaves open randomized confirmation of clinical cardiotoxicity reduction.
PURPOSE: Adjuvant radiotherapy of breast cancer using a photon tangential field incurs a risk of late heart and lung toxicity. The use of free breathing (FB), expiration breath hold (EBH), and deep inspiration breath hold (DIBH) during tangential breast radiotherapy as a means of reducing irradiated lung and heart volume was evaluated. METHODS: In 10 women with left-sided breast cancer (mean age, 44 years) post-operative computed tomography (CT) scanning was done under different respiratory conditions using FB, EBH, and DIBH in 3 CT scans. For each scan, an optimized radiotherapy plan was designed with 6 MV photon tangential fields encompassing the clinical target volume after breast-conserving surgery. RESULTS: The results of dose-volume histograms were compared using three breathing pattern techniques for the irradiated volume and dose to the heart. A significant reduction dose to the irradiated heart volume for the DIBH breathing technique was compared to FB and EBH breathing techniques (p<0.05). CONCLUSION: This study demonstrated that the irradiated heart volume can be significantly reduced in patients with left-sided breast cancer using the DIBH breathing technique for tangential radiotherapy.
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Shim et al. (2012) conducted an observational in Left-sided breast cancer (n=10). Deep inspiration breath hold (DIBH) vs. Free breathing (FB) was evaluated on Minimum dose to 5% of the heart volume (D5) (p=0.004). Deep inspiration breath hold significantly reduced the minimum dose to 5% of the heart volume (5.26 Gy vs 15.33 Gy) compared to free breathing in left-sided breast cancer patients.
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