Cardiac Dose Reduction with Deep-Inspiratory Breath Hold Technique of Radiotherapy for Left-Sided Breast Cancer

Different techniques of radiation therapy have been studied to reduce the cardiac dose in left breast cancer. In this prospective dosimetric study, the doses to heart as well as other organs at risk (OAR) were compared between free-breathing (FB) and deep inspiratory breath hold (DIBH) techniques in...

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Bibliographic Details
Published in:	Journal of medical physics Vol. 42; no. 3; pp. 123 - 127
Main Authors:	Sripathi, Lalitha Kameshwari, Ahlawat, Parveen, Simson, David K, Khadanga, Chira Ranjan, Kamarsu, Lakshmipathi, Surana, Shital Kumar, Arasu, Kavi, Singh, Harpreet
Format:	Journal Article
Language:	English
Published:	India Medknow Publications and Media Pvt. Ltd 01-07-2017 Medknow Publications & Media Pvt. Ltd Medknow Publications & Media Pvt Ltd Wolters Kluwer Medknow Publications
Subjects:	Breast cancer Breathing Cancer Cancer research Cancer therapies CAT scans Computed tomography Computer simulation Deep-inspiratory breath hold Dosimetry Heart Homogeneity intensity modulated radiotherapy left anterior descending Mastectomy Medical equipment industry Methods Oncology Organs Original Patients Planning Radiation therapy Radiotherapy Reduction Respiration Spinal cord Studies three-dimensional radiotherapy Tomography United States intensity modulated radiotherapy three-dimensional radiotherapy left anterior descending Deep-inspiratory breath hold
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Summary:	Different techniques of radiation therapy have been studied to reduce the cardiac dose in left breast cancer. In this prospective dosimetric study, the doses to heart as well as other organs at risk (OAR) were compared between free-breathing (FB) and deep inspiratory breath hold (DIBH) techniques in intensity modulated radiotherapy (IMRT) and opposed-tangent three-dimensional radiotherapy (3DCRT) plans. Fifteen patients with left-sided breast cancer underwent computed tomography simulation and images were obtained in both FB and DIBH. Radiotherapy plans were generated with 3DCRT and IMRT techniques in FB and DIBH images in each patient. Target coverage, conformity index, homogeneity index, and mean dose to heart (Heart D ), left lung, left anterior descending artery (LAD) and right breast were compared between the four plans using the Wilcoxon signed rank test. Target coverage was adequate with both 3DCRT and IMRT plans, but IMRT plans showed better conformity and homogeneity. A statistically significant dose reduction of all OARs was found with DIBH. 3DCRT decreased the Heart D by 53.5% (7.1 vs. 3.3 Gy) and mean dose to LAD by 28% compared to 3DCRT . IMRT further lowered mean LAD dose by 18%. Heart D was lower with 3DCRT over IMRT (3.3 vs. 10.2 Gy). Mean dose to the contralateral breast was also lower with 3DCRT over IMRT (0.32 vs. 3.35 Gy). Mean dose and the V of ipsilateral lung were lower with 3DCRT over IMRT (13.78 vs. 18.9 Gy) and (25.16 vs. 32.95%), respectively. 3DCRT provided excellent dosimetric results in patients with left-sided breast cancer without the need for IMRT.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0971-6203 1998-3913
DOI:	10.4103/jmp.JMP_139_16