Contribution of Respiratory Gating Techniques for Optimization of Breast Cancer Radiotherapy

Giraud, P.; Djadi-Prat, Juliette; Morelle, M.; Pourel, N.; Durdux, C.; Carrié, C.; Daveau, C.; Carrère, Marie‐Odile; Centers, Stic Study

doi:10.3109/07357907.2012.657818

Cited by 35 publications

(27 citation statements)

References 15 publications

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“…The magnitude of relative reduction in the MHD (62%) is consistent with retrospective studies in which the value ranged 40% to 62% [7-9]. Our dosimetric findings may generalize to other mDIBH devices like the SDX system (Dyn’R, Toulouse, France) as previously demonstrated [10]. The Real-time Position Management (RPM) system (Varian, Palo Alto, CA) has also been demonstrated to provide significant reduction in cardiac dose; however, in a comparison of RPM with ABC, Giraud et al demonstrated greater lung inflation and lower heart V 40 Gy, maximum heart dose, and MHD with ABC [10].…”

Section: Discussionsupporting

confidence: 89%

“…We hypothesized that use of the ABC device would reduce MHD by 20% or greater. Since initiation of this trial, dosimetric data with the ABC device have been reported [7-9], but data from prospective trials remains limited [10, 11] and long-term oncologic outcomes are unknown. We present the dosimetric endpoints and long-term clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Active Breathing Coordinator reduces radiation dose to the heart and preserves local control in patients with left breast cancer: Report of a prospective trial

Eldredge-Hindy

Lockamy

Crawford

et al. 2015

Practical Radiation Oncology

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Purpose-Incidental radiation dose to the heart and lung during breast radiotherapy (RT) has been associated with an increased risk of cardiopulmonary morbidity. We conducted a prospective trial to determine if RT with the Active Breathing Coordinator (ABC) can reduce the mean heart dose (MHD) by ≥20% and dose to the lung.Methods & Materials-Patients with Stages 0-III left breast cancer (LBC) were enrolled and underwent simulation with both free breathing (FB) and ABC for comparison of dosimetry. ABC was used during the patient's RT course if the MHD was reduced by ≥5%. The median prescription dose was 50.4 Gy plus a boost in 77 patients (90%). The primary endpoint was the magnitude of MHD reduction when comparing ABC to FB. Secondary endpoints included dose reduction to the heart and lung, procedural success rate, and adverse events.Results-112 pts with LBC were enrolled from 2002 to 2011 and 86 eligible patients underwent both FB and ABC simulation. Ultimately, 81 pts received RT using ABC, corresponding to 72% procedural success. The primary endpoint was achieved as use of ABC reduced MHD by 20% or greater in 88% of patients (p<0.0001). The median values for absolute and relative reduction in MHD were 1.7 Gy and 62%, respectively. RT with ABC provided a statistically significant dose reduction to the left lung. After a median follow up of 81 mos., 8-year estimates of locoregional relapse, disease-free, and overall survival were 7%, 90%, and 96%, respectively.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Active Breathing Coordinator reduces radiation dose to the heart and preserves local control in patients with left breast cancer: Report of a prospective trial

Eldredge-Hindy

Lockamy

Crawford

et al. 2015

Practical Radiation Oncology

View full text Add to dashboard Cite

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“…was used as guideline in our study 27. There is a decreased volume of the heart during DIBH which is probably due to increased intrathoracic pressure, and this is consistent with other studies that have found a 5%–10% reduction 6, 41. Another limitation was that the laser system had a fixed measuring point in the room; all patients had their isocenter placed on the sternum.…”

Section: Discussionsupporting

confidence: 82%

Monitoring deep inspiration breath hold for left‐sided localized breast cancer radiotherapy with an in‐house developed laser distance meter system

Jensen

Абрамова

Frengen

et al. 2017

J Applied Clin Med Phys

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Deep inspiration breath hold (DIBH) in left‐sided breast cancer radiotherapy is a technique to reduce cardiac and pulmonary doses while maintaining target coverage. This study aims at evaluating an in‐house developed DIBH system. Free‐breathing (FB) and DIBH plans were generated for 22 left‐sided localized breast cancer patients who had radiation therapy (RT) after breast‐conserving surgery. All patients were treated utilizing an in‐house laser distance measuring system. 50 Gy was prescribed, and parameters of interest were target coverage, left anterior descending coronary artery, (LAD) and heart doses. Portal images were acquired and the reproducibility and stability of DIBH treatment were compared to FB. The comparing result shows there is a significant reduction in all LAD and heart dose statistics for DIBH compared to FB plans without compromising the target coverage. The maximum LAD dose was reduced from 43.7 Gy to 29.0 Gy and the volume of the heart receiving >25 Gy was reduced from 3.3% to 1.0% using the in‐house system, both statistically significant. The in‐house system gave a reproducible and stable DIBH treatment where the systematic error ∑, and random error σ, were less than 2.2 mm in all directions, but were not significantly better than at FB. The system was well tolerated and all patients completed their treatment sessions with DIBH.

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“…In this study we wanted to investigate whether DIBH could further reduce heart dose metrics for prone WBI. Comparable to DIBH in supine position [17][18][19][20][21][22][23][24][25]; prone DIBH enabled an approximately 40% mean heart dose reduction compared to prone SB. Moreover, in the explorative trial, prone DIBH was at least as favorable as supine DIBH regarding heart dose.…”

Section: Discussionmentioning

confidence: 82%

“…volume [9][10][11][12]. Irradiation during deep inspiration has been successfully implemented in supine WBI to reduce heart dose without increasing dose to other OARs [19][20][21][22][23][24][25]. Deep inspiration breath hold (DIBH) increases the distance between heart and breast compared to normal or shallow breathing (SB).…”

mentioning

confidence: 99%

Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

Mulliez

Veldeman

Speleers

et al. 2015

Radiotherapy and Oncology

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Contribution of Respiratory Gating Techniques for Optimization of Breast Cancer Radiotherapy

Cited by 35 publications

References 15 publications

Active Breathing Coordinator reduces radiation dose to the heart and preserves local control in patients with left breast cancer: Report of a prospective trial

Active Breathing Coordinator reduces radiation dose to the heart and preserves local control in patients with left breast cancer: Report of a prospective trial

Monitoring deep inspiration breath hold for left‐sided localized breast cancer radiotherapy with an in‐house developed laser distance meter system

Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

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