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Strahlentherapie und Onkologie

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01.09.2015 | Original Article

Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer

Dosimetrical comparison and clinical feasibility in 20 patients

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 9/2015

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Abstract

Background

Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients’ acceptance/compliance and associated additional workload.

Materials and methods

Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm³ (D_2 cm ³), volume receiving ≥ 5 Gy (V₅), 10 Gy (V₁₀), 15 Gy (V₁₅) and 20 Gy (V₂₀). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test.

Results

DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D_2 cm ³ was less than 42 Gy in DIBH. In FB the heart D_2 cm ³ was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min.

Conclusion

Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL.

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Titel: Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer
Dosimetrical comparison and clinical feasibility in 20 patients
Publikationsdatum: 01.09.2015
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 9/2015
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0838-y

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Springer Medizin

Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer

Dosimetrical comparison and clinical feasibility in 20 patients

Abstract

Background

Materials and methods

Results

Conclusion

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Springer Medizin

Abstract

Background

Materials and methods

Results

Conclusion

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