Deep inspiration breath hold reduces the mean heart dose in left breast cancer radiotherapy
| Autor: | Bartłomiej Masojć, Michał Falco, Piotr Woźniak, Magdalena Łukowiak, Agnieszka Macała, Julian Malicki |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Organs at Risk
medicine.medical_specialty Time Factors medicine.medical_treatment R895-920 mean heart dose Radiation Dosage 030218 nuclear medicine & medical imaging Breath Holding 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Breast cancer breast cancer medicine Confidence Intervals Unilateral Breast Neoplasms Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Radiation Injuries Deep inspiration breath-hold Retrospective Studies deep inspiration breath hold business.industry Cancer Retrospective cohort study Heart medicine.disease Radiation therapy Left breast Oncology Inhalation gated radiotherapy 030220 oncology & carcinogenesis Cohort Female Radiology Radiotherapy Intensity-Modulated free breathing gated radiotherapy business Research Article |
| Zdroj: | Radiology and Oncology, Vol 55, Iss 2, Pp 212-220 (2021) Radiology and Oncology |
| ISSN: | 1581-3207 |
| Popis: | Background Patients with left breast cancer who undergo radiotherapy have a non-negligible risk of developing radiation-induced cardiovascular disease (CVD). Cardioprotection can be achieved through better treatment planning protocols and through respiratory gating techniques, including deep inspiration breath hold (DIBH). Several dosimetric studies have shown that DIBH reduces the cardiac dose, but clinical data confirming this effect is limited. The aim of the study was to compare the mean heart dose (MHD) in patients with left breast cancer who underwent radiotherapy at our institution as we transitioned from non-gated free-breathing (FB) radiotherapy to gated radiotherapy (FB-GRT), and finally to DIBH. Patients and methods Retrospective study involving 2022 breast cancer patients who underwent radiotherapy at West Pomeranian Oncology Center in Szczecin from January 1, 2014 through December 31, 2017. We compared the MHD in these patients according to year of treatment and technique. Results Overall, the MHD for patients with left breast cancer in our cohort was 3.37 Gy. MHD values in the patients treated with DIBH were significantly lower than in patients treated with non-gated FB (2.1 vs. 3.48 Gy, p < 0.0001) and gated FB (3.28 Gy, p < 0.0001). The lowest MHD values over the four-year period were observed in 2017, when nearly 85% of left breast cancer patients were treated with DIBH. The proportion of patients exposed to high (> 4 Gy) MHD values decreased every year, from 40% in 2014 to 7.9% in 2017, while the percentage of patients receiving DIBH increased. Conclusions Compared to free-breathing techniques (both gated and non-gated), DIBH reduces the mean radiation dose to the heart in patients with left breast cancer. These findings support the use of DIBH in patients with left breast cancer treated with radiotherapy. |
| Databáze: | OpenAIRE |
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