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Journal of Radiation Oncology

, Volume 8, Issue 1, pp 89–96 | Cite as

Comparison of deep inspiration breath hold and free breathing technique in left breast cancer irradiation: a dosimetric evaluation in 40 patients

  • Dario AielloEmail author
  • Giuseppina Rita Borzì
  • Lorenza Marino
  • Vincenza Umina
  • Alfio Michelangelo Di Grazia
Original Research
  • 17 Downloads

Abstract

Objective

To analyze the reduction of dose to organs at risk between deep inspiration breath hold (DIBH) and free breathing (FB) techniques in left breast irradiation.

Methods

Forty left-sided breast cancer patients received adjuvant radiotherapy and were retrospectively analyzed. Treatment plans were generated on both DIBH and FB computed tomography (CT) scans. The patients were monitored by the Varian RPM™ respiratory gating system. The treatment planning was performed with conformal tangential fields by means of 6 and 10 MV photon fields. Treatment schedule were 50 Gy in 25 fractions (conventional schedule) or 40.05 Gy in 15 fractions (hypofractionated schedule), with or without sequential boost to tumor bed. Dose-volume histograms were compared for all plans. For the comparison, we considered cardiac and ipsilateral lung doses and volumes. Quantitative statistical analyses of plans dose differences were generated. In order to correlate the mean cardiac dose difference between the FB and DIBH techniques with maximum heart distance (MHD), a linear regression model was used.

Results

A statistically significant reduction of cardiac and pulmonary doses using the DIBH technique was achieved compared with FB plans, maintaining an equal coverage of planning target volume (PTV). A positive correlation was found between MHD and mean heart dose difference.

Conclusion

Our study confirms the DIBH technique advantage in reducing cardiac and pulmonary doses for tangentially treated left-sided breast cancer patients. Further research is warranted to evaluate potential long-term clinical implications of these relevant dosimetry results.

Keywords

Breast cancer Radiation therapy Gating Deep inspiration breath hold Cardiac dose Left anterior descending coronary artery 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of ethical standards

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Radiation OncologyFondazione Istituto Oncologico del MediterraneoCataniaItaly
  2. 2.REM RadioterapiaCataniaItaly

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