Left-sided Breast Cancer Irradiation With Deep Inspiration Breath-hold: Changes in Heart and Lung Dose in Two Periods

In Vivo. 2022 Jan-Feb;36(1):314-324. doi: 10.21873/invivo.12704.

Abstract

Background/aim: Post-operative radiotherapy for breast cancer can increase cardiac disease in a dose-dependent manner. In this study we show the reduction of dose to heart and left anterior descending artery (LAD) which can be achieved by using "Deep inspiration breath-hold" (DIBH) technique.

Patients and methods: Tangential 3D-planned radiation was delivered to 357 patients with left-sided breast cancer, 159 of them with the DIBH technique. A distinction was made according to fractionation scheme.

Results: The mean heart dose was significantly reduced by DIBH from 2.64 Gy to 1.39 Gy (p<0.001). The mean dose to the LAD was significantly reduced from 5.68 Gy to 3.88 Gy (p<0.001). Mean dose and volume receiving 5, 10 and 15 Gy of ipsilateral lung were higher with both hypofractionated schedule and conventional fractionation in the DIBH group.

Conclusion: DIBH in left-sided breast irradiation is an effective method of reducing the radiogenic heart dose.

Keywords: 3D-planned tangential radiotherapy (3D-CRT); Breast cancer; deep inspiration breath-hold (DIBH).

MeSH terms

  • Breast Neoplasms* / radiotherapy
  • Breath Holding
  • Female
  • Heart
  • Humans
  • Lung
  • Organs at Risk
  • Radiotherapy Dosage
  • Unilateral Breast Neoplasms* / radiotherapy