Purpose: To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB.
Methods: Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans. Dose to PTV was 50 Gy in 25 fractions. Two treatment plans were generated for each patient: FB-3D-CRT and DIBH-3D-CRT. Dosimetry parameters were obtained from dose volume histograms. Data were compared using the paired-sample Wilcoxon signed rank test.
Results: For heart, LADCA, and left lung, a significant dose reduction was found using DIBH technique. By using DIBH, an average reduction of 25% was observed in LADCA for the volume receiving 20 Gy and of 48% considering the mean heart dose.
Conclusions: The DIBH technique results in a significant decrease of dose to the heart, LADCA, and left lung compared to FB.
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http://dx.doi.org/10.5301/tj.5000563 | DOI Listing |
Clin Transl Radiat Oncol
March 2025
Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Purpose: To use imaging data from stereotactic MR-guided online adaptive radiotherapy (SMART) of ultracentral lung tumors (ULT) for development of a safe non-adaptive approach towards stereotactic body radiotherapy (SBRT) of ULT.
Patients And Methods: Analysis is based on 19 patients with ULT who received SMART (10 × 5.0-5.
Radiography (Lond)
January 2025
School of Nursing, The Hong Kong Polytechnic University, Hong Kong. Electronic address:
Introduction: Deep inspiration breath hold technique has shown promise in reducing cardiac toxicity and improving patient outcomes. However, there is a lack of consensus regarding the implementation of abdominal breath hold technique and its impact on cardiac dose. This systematic review and meta-analysis aim to provide insights into the comparative effectiveness of abdominal and thoracic breath hold in mitigating cardiac toxicity during radiation therapy for left-sided breast cancer.
View Article and Find Full Text PDFSemin Radiat Oncol
January 2025
Department of Radiation Oncology, Institut Curie, Paris, France.
Radiotherapy has a long history in the treatment of lymphoma and leukemia, in which late toxicity outcomes have motivated current goals to improve how radiotherapy is delivered. Contemporary advanced radiotherapy techniques, including intensity modulated radiation therapy (IMRT), proton therapy, deep inspiration breath hold (DIBH), aim to reduce the risk of cardiac morbidity and second cancers caused by radiotherapy while maintaining local control. We use treatment of mediastinal and gastric lymphomas to introduce how modern techniques are chosen for optimal dose delivery, followed by an anatomic site-specific discussion of testicular, bone, and central nervous system disease.
View Article and Find Full Text PDFTher Radiol Oncol
December 2023
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Background: Advanced bilateral breast cancers with local and regional nodal involvement are rare and challenging to plan due to conflicting demands of conformality, uniformity and sparing of organs at risk such as heart and lungs. Pencil beam scanning (PBS) protons have been shown to provide improved organ at risk (OAR) sparing, conformality and homogeneity compared to photon techniques including three-dimensional conformal radiotherapy, intensity modulated radiation therapy (IMRT), volumetric arc therapy (VMAT), and tomotherapy. We performed a blinded comparison between VMAT and PBS plans and extend this comparison with a case study of a patient win expander during radiotherapy.
View Article and Find Full Text PDFBiomed Phys Eng Express
December 2024
Department of Medical Physics, Tom Baker Cancer Centre, 1331 29 St NW, Calgary, Alberta, T2N 4N2, CANADA.
This study presents machine learning (ML) models that predict if deep inspiration breath hold (DIBH) is needed based on lung dose in right-sided breast cancer patients during the initial computed tomography (CT) appointment. Materials and methods. Anatomic distances were extracted from a single-institution dataset of free breathing (FB) CT scans from locoregional right-sided breast cancer patients.
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