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Comparison of thoracic and abdominal deep inspiration breath holds in whole-breast irradiation for patients with left-sided breast cancer

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Abstract

Background

The deep inspiration breath hold (DIBH) technique is effective for heart dose reduction in patients with left-sided breast cancer. In deep breathing, some women breathe in thoracic respiration; and others, in abdominal respiration. This study evaluated differences in dose reduction in organs at risk (OAR) and reproducibilities of the target and OAR between thoracic DIBH (T-DIBH) and abdominal DIBH (A-DIBH).

Methods

Fourteen patients with left-sided breast cancer who had planned to receive whole-breast irradiation were included. Computed tomography (CT) was performed in free breathing (FB), T-DIBH, and A-DIBH, and the dosimetric indexes of the target and OAR for three treatment plans were compared. In T-DIBH and A-DIBH, two series CTs were taken in each breathing method and the displacements of the target and heart were calculated.

Results

The averaged mean heart doses (MHDs) were 1.5 Gy and 1.6 Gy in T-DIBH and A-DIBH, respectively, significantly lower than 2.7 Gy in FB (p < 0.001 for both breathing methods). Between T-DIBH and A-DIBH, no significant difference in MHD was found (p = 0.95); however, the percentage increase in lung volume positively moderately correlated with the reduction in MHD (R = 0.68). The three-dimensional target displacements were 2.3 mm in T-DIBH and 2.0 mm in A-DIBH (p = 0.64). The three-dimensional heart displacements were 1.7 mm in T-DIBH and 1.8 mm in A-DIBH (p = 0.85).

Conclusion

The present study demonstrates that the MHD and reproducibility did not differ between T-DIBH and A-DIBH. However, the superior breathing method for increasing lung volume should be determined for each patient.

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Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

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Authors and Affiliations

  1. Department of Radiation Oncology, Kyoto City Hospital, 1-2 Mibu Higashi Takadacho, Nakagyo-ku, Kyoto, 604-8845, Japan

    Kimiko Hirata, Masaru Narabayashi & Shuji Ohtsu

  2. Clinical Radiology Service Division, Kyoto City Hospital, 1-2 Mibu Higashi Takadacho, Nakagyo-ku, Kyoto, 604-8845, Japan

    Yuki Hanai, Kenta Fukumoto, Tomohiro Kosuga & Kazunori Tanaka

  3. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan

    Nobutaka Mukumoto

Authors
  1. Kimiko Hirata
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  2. Masaru Narabayashi
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  3. Yuki Hanai
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  4. Kenta Fukumoto
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  5. Tomohiro Kosuga
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  6. Kazunori Tanaka
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  7. Nobutaka Mukumoto
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  8. Shuji Ohtsu
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by KH, MN, YH, KF, TK, KT, and SO. Data analysis was performed by KH and NM. The first draft of the manuscript was written by Kimiko Hirata and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kimiko Hirata.

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The authors declare no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Research involving human participants

This study was approved by our institutional review board.

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Hirata, K., Narabayashi, M., Hanai, Y. et al. Comparison of thoracic and abdominal deep inspiration breath holds in whole-breast irradiation for patients with left-sided breast cancer. Breast Cancer 28, 1154–1162 (2021). https://doi.org/10.1007/s12282-021-01259-4

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  • DOI: https://doi.org/10.1007/s12282-021-01259-4

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