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Radiother Oncol. 2013 Jan;106(1):28-32. doi: 10.1016/j.radonc.2012.10.016. Epub 2012 Nov 28.

Improved heart, lung and target dose with deep inspiration breath hold in a large clinical series of breast cancer patients.

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  • 1Department of Medical Physics, Vejle Hospital, Denmark. henrik.dahl.nissen@slb.regionsyddanmark.dk

Abstract

BACKGROUND AND PURPOSE:

This study aims at evaluating the effect of deep-inspiration breath hold (DIBH) on target coverage and dose to organs at risk in a large series of breast cancer patients.

MATERIALS AND METHODS:

Clinical dose plans for 319 breast cancer patients were evaluated: 144 left-sided patients treated with DIBH and 175 free-breathing (FB) patients (83 left-sided and 92 right-sided). All patients received whole breast irradiation with tangential fields, based on a forward-planned intensity-modulated radiation therapy (IMRT) technique. Dose to heart, ipsi-lateral lung and ipsi-lateral breast were assessed and median values compared between patient groups.

RESULTS:

Comparing group median values, DIBH plans show large reductions of dose to the heart compared with left-sided FB plans; V(20 Gy) (relative volume receiving ≥ 20 Gy) for the heart is reduced from 7.8% to 2.3% (-70%, p < 0.0001), V(40 Gy) from 3.4% to 0.3% (-91%, p < 0.0001) and mean dose from 5.2 to 2.7 Gy (-48%, p < 0.0001). Lung dose also shows a small reduction in V(20 Gy) (p < 0.04), while median target coverage is slightly improved (p = 0.0002).

CONCLUSIONS:

In a large series of clinical patients we find that implementation of DIBH in daily clinical practice results in reduced irradiation of heart and lung, without compromising target coverage.

PMID:
23199652
DOI:
10.1016/j.radonc.2012.10.016
[PubMed - indexed for MEDLINE]
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