Abdominal DIBH reduces the cardiac dose even further: a prospective analysis

Autor:	Feng Zhao, Jiayan Shen, Zhongjie Lu, Yongbiao Luo, Guorong Yao, Luyi Bu, Jia Ge, Xin Yang, Lihua Ning, Senxiang Yan
Jazyk:	angličtina
Rok vydání:	2018
Předmět:	Breast cancer Breath holding 3-dimensional conformal radiation therapy (3D-CRT) Intensity-modulated radiation therapy (IMRT) Organs at risk Radiotherapy dosage Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Zdroj:	Radiation Oncology, Vol 13, Iss 1, Pp 1-8 (2018)
Druh dokumentu:	article
ISSN:	1748-717X
DOI:	10.1186/s13014-018-1062-6
Popis:	Abstract Background Deep inspiration breath hold (DIBH) can be performed using different breathing maneuvers, such as DIBH with a thoracic breathing maneuver (T-DIBH) and DIBH with an abdominal breathing maneuver (A-DIBH). Dosimetric benefits of A-DIBH were investigated in the treatment of left-sided breast cancer radiotherapy (RT) with both 3-Dimensional conformal radiation therapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) techniques. Methods Twenty-two patients with left-sided breast cancer were enrolled in this study. 3D-CRT and IMRT plans were generated for each patient with three different CT scans of free breathing (FB), T-DIBH and A-DIBH. There were total of six treatment plans generated for each patient: FB_3D-CRT; TDIBH_3D-CRT; ADIBH_3D-CRT; FB-IMRT; TDIBH-IMRT; ADIBH-IMRT. Doses to the heart, left anterior descending coronary artery (LADCA), and ipsilateral lung were evaluated and compared using the Wilcoxon signed-rank test. Results The mean doses to the heart, LADCA and ipsilateral lung in 3D-CRT plans generated from 3D-CRT with FB, T-DIBH and A-DIBH were (2.89 ± 1.30), (1.67 ± 0.90) and (1.34 ± 0.43) Gy (all P 0.05), respectively, with A-DIBH. Conclusions This study indicates that both 3D-CRT and IMRT plans with A-DIBH achieved lower cardiac and LADCA doses than plans with FB and T-DIBH; 3D-CRT plans with A-DIBH achieved lower ipsilateral lung doses than plans with FB and T-DIBH; and IMRT plans with A-DIBH had better outcomes than 3D-CRT plans with A-DIBH with respect to the mean dose to the heart, LADCA and ipsilateral lung. IMRT plans with A-DIBH should be incorporated into the daily routine for left-sided breast RT.
Databáze:	Directory of Open Access Journals
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