The effect of deep inspiration breath-hold technique on left anterior descending coronary artery and heart dose in left breast irradiation

Sakyanun, Pitchaya; Saksornchai, Kitwadee; Nantavithya, Chonnipa; Chakkabat, Chakkapong; Shotelersuk, Kanjana

doi:10.3857/roj.2020.00094

Cited by 19 publications

(17 citation statements)

References 21 publications

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“…Neste estudo, a unidade 1 ficou próximo ao limite determinado, entretanto os demais casos permaneceram em um nível significativamente a abaixo. Com exceção da unidade 1, o achado deste estudo foi condizente com Sakyanun et al (2020) que em seu estudo obteve o V25Gy de 2,9%.…”

Section: Resultsunclassified

Dose cardíaca nos tratamentos radioterápicos para câncer de mama esquerda: uso da técnica Deep Inspiration Breath Hold

Silva

Dorow

Müller

et al. 2021

RSD

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Introdução: o tratamento radioterápico para câncer de mama esquerda tem como consequência a cardiotoxicidade induzida por radiação. A partir da necessidade de minimizar as doses cardíacas, surgiu a técnica Deep Inspiration Breath Hold (DIBH). Objetivo: descrever as doses nas estruturas cardíacas por meio do Histograma Dose Volume (DVH) no tratamento radioterápico para câncer de mama esquerda com a técnica DIBH. Metodologia: a pesquisa se caracterizada como estudo de caso com múltiplas unidades de análise, do tipo descritivo, de natureza retrospectiva e com abordagem quantitativa. Resultados: a amostra foi composta por cinco unidades de análise. A dose média cardíaca para a técnica DIBH foi de 6 Gy; e para a artéria coronária descendente anterior esquerda, esta foi de 14,8 Gy. Quatro unidades de análise foram mais beneficiadas com a técnica, o resultado é justificado pela modalidade cirúrgica conservadora, enquanto uma unidade apresentou o menor benefício, uma vez que realizou mastectomia. Conclusão: a DIBH é uma alternativa para reduzir a toxicidade cardíaca em mulheres que realizam radioterapia para câncer de mama esquerda, principalmente em indivíduos que possuem outros fatores de risco associados à doença cardíaca.

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Section: Resultsunclassified

Dose cardíaca nos tratamentos radioterápicos para câncer de mama esquerda: uso da técnica Deep Inspiration Breath Hold

Silva

Dorow

Müller

et al. 2021

RSD

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“…Several studies ( 20 , 21 , 26 ) have demonstrated that the maximum heart distance (MHD) is a good predictor of the mean heart dose. The MHD was measured as the maximum width of the heart in the tangent fields.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of dosimetry and predictive somatotype parameters of prone and supine whole-breast irradiation among Chinese women after breast-conserving surgery

et al. 2022

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PurposeFinding a better treatment position (prone or supine) for whole-breast irradiation for Chinese female patients diagnosed with breast cancer by identify the associations between predictive somatotype parameters and dosimetric gains.Materials and methodsTwo volumetric-modulated arc therapy (VMAT) plans were deployed for whole-breast irradiation in supine and prone position with a total dose of 50 Gy in 25 fractions. Dose-volume parameters were compared and analysed both in the target volume and organs at risk, and equivalent uniform dose-based figure-of-merit (fEUD) models were further used to quantitatively evaluate the overall merits of the two plans. Body shape parameters, including body mass index (BMI), body surface area (BSA), breast shape, cup size, bust size and chest size, were collected. Anatomic features such as the central heart distance (CHD) were measured on supine CT. Spearman’s correlation analysis, receiver operating characteristic (ROC) curve analysis, and the linear regression models were conducted.ResultsDoses to the heart and left anterior descending coronary artery (LADCA) are greater in left-sided breast cancer (BC) patients in the prone position than in the supine position, and the opposite was true for right-sided BC patients (p<0.001). 19 of 63 patients (5 left-sided and 14 right-sided BC) achieved greater benefit from the prone position according to the fEUD score. Right-sided BC patients with a bust size ≥92.25 cm, drop-type breasts and cup size ≥B are very likely to benefit from prone-position radiotherapy. The CHD is significantly positively associated with △fEUD among right-sided BC patients (rho=0.506, p=0.004). Using a cut-off point of 2.215, the CHD had 71.4% sensitivity and 81.2% specificity in predicting a successful prone plan.ConclusionsRight-sided BC patients had better dosimetric gain in the prone position than left-sided BC patients. The CHD is an especially good and novel predictor that could help to select prone-benefitting right-sided BC patients.

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“…The DIBH method is capable to reduce the dose to the heart, LAD and RCA. 28,29 Nevertheless, this practice might not be achievable for all patients. Holding the breath for a few minutes is a difficult task for certain patients.…”

Section: Discussionmentioning

confidence: 99%

Accelerated hypofractionated radiotherapy for chest wall and nodal irradiation using hybrid techniques

Balaji

Ramasubramanian

2021

J Radiother Pract

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Aim: This study compares three different hybrid plans, for left-sided chest wall (CW) and nodal stations irradiation using a hypofractionated dose regimen. Materials and methods: Planning target volumes (PTVs) of 25 breast cancer patients that included CW, supraclavicular (SCL) and internal mammary node (IMN) were planned with 3 different hybrid techniques: 3DCRT+IMRT, 3DCRT+VMAT and IMRT+VMAT. All hybrid plans were generated with a hypofractionated dose prescription of 40·5 Gy in 15 fractions. Seventy per cent of the dose was planned with the base-dose component and remaining 30% of the dose was planned with the hybrid component. All plans were evaluated based on the PTVs and organs at risk (OARs) dosimetric parameters. Results: The results for PTVs parameters have shown that the 3DCRT+IMRT and 3DCRT+VMAT plans were superior in uniformity index to the IMRT+VMAT plan. The OARs dose parameters were comparable between hybrid plans. The IMRT+VMAT plan provided a larger low dose volume spread to the heart and ipsilateral lung (p < 0·001). The 3DCRT+VMAT plan required less monitor units and treatment time (p = 0·005) than other plans. Conclusion: The 3DCRT+VMAT hybrid plan showed superior results with efficient treatment delivery and provide clinical benefit by reducing both low and high dose levels.

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The effect of deep inspiration breath-hold technique on left anterior descending coronary artery and heart dose in left breast irradiation

Cited by 19 publications

References 21 publications

Dose cardíaca nos tratamentos radioterápicos para câncer de mama esquerda: uso da técnica Deep Inspiration Breath Hold

Dose cardíaca nos tratamentos radioterápicos para câncer de mama esquerda: uso da técnica Deep Inspiration Breath Hold

Comparative analysis of dosimetry and predictive somatotype parameters of prone and supine whole-breast irradiation among Chinese women after breast-conserving surgery

Accelerated hypofractionated radiotherapy for chest wall and nodal irradiation using hybrid techniques

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