Dosimetric evaluation of critical organs at risk in mastectomized left-sided breast cancer radiotherapy using breath-hold technique

Tumori. 2013 Jan-Feb;99(1):76-82. doi: 10.1177/030089161309900113.

Abstract

Aims and background: The aim of the study was to evaluate the dosimetric impact of the active breathing control-moderate deep inspiration breath-hold (ABC-mDIBH) technique on normal tissue sparing in locally advanced left-sided breast cancer radiotherapy.

Methods and study design: Twenty-seven consecutive patients with left-sided locally advanced breast cancer referred to our department for adjuvant radiotherapy were enrolled in the study. Each patient was scanned at free breathing and ABC-mDIBH for radiation treatment planning. Two separate radiotherapy treatment plans were generated with and without ABC-mDIBH to investigate the dosimetric impact of ABC-mDIBH in breast cancer radiotherapy.

Results: Between June 2011 and February 2012, 27 consecutive patients with left-sided locally advanced breast cancer referred to our department for adjuvant radiotherapy were enrolled in the study. Dose-volume parameters of left anterior descending coronary artery, lungs, heart, contralateral breast, esophagus and spinal cord were significantly reduced with the use of ABC-mDIBH (P <0.001).

Conclusions: Our study revealed that the use of ABC-mDIBH in the practice of locally advanced mastectomized left-sided breast cancer radiotherapy improves normal tissue sparing with the expected potential of decreasing treatment-related morbidity and mortality. Moreover, the resultant reduction achieved with ABC in doses to the left anterior descending coronary artery, which plays a central role in cardiac perfusion, may have implications for decreasing the potential of radiation-induced cardiac morbidity and mortality.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Breast / radiation effects
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery
  • Breath Holding*
  • Coronary Vessels / radiation effects
  • Dose Fractionation, Radiation
  • Esophagus / radiation effects
  • Female
  • Heart / radiation effects
  • Humans
  • Imaging, Three-Dimensional
  • Immobilization / methods
  • Lung / radiation effects
  • Mastectomy*
  • Middle Aged
  • Organs at Risk / radiation effects*
  • Radiation Injuries / prevention & control*
  • Radiometry
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Adjuvant
  • Spinal Cord / radiation effects
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Turkey