Dosimetric Evaluation of Deep Inspiration Breath-HoldTechnique for Breast Cancer Radiotherapy: A Single-Center Experience

Dosimetric Evaluation of Deep Inspiration Breath-HoldTechnique for Breast Cancer Radiotherapy: A Single-Center Experience

To retrospectively evaluate the absorbed doses of organs at risk, such as lungs and the heart of the patients who underwent radiotherapy (RT) using the voluntary deep inspiration breath-hold (vDIBH) technique, and to compare the results with the literature.METHODSIn this study, 102 patients who underwent adjuvant RT for the treatment of breast cancer in our clinic between November 2018 and December 2019 were included. A breast and/or chest wall, and/or lymph node RT of 50 Gy in 25 fractions was planned for all patients, and an additional boost of 10 Gy in five fractions was planned for patients requiring an RT boost. The treatment plans included 3DCRT, Field in Field (FIF), IMRT and VMAT approaches.RESULTSIn the group undergoing supraclavicular fossa RT, the mean V20Gy was found to be 24.8%, compared to 16% in the group not undergoing supraclavicular fossa RT (p

___

  • 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424.
  • 2. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 2011;378(9804):1707–16.
  • 3. Darby SC, McGale P, Taylor CW, Peto R. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. Lancet Oncol 2005;6(8):557–65.
  • 4. Cuzick J, Stewart H, Rutqvist L, Houghton J, Edwards R, Redmond C, et al. Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol 1994;12(3):447–53.
  • 5. Aznar MC, Duane FK, Darby SC, Wang Z, Taylor CW. Exposure of the lungs in breast cancer radiotherapy: A systematic review of lung doses published 2010-2015. Radiother Oncol 2018;126(1):148–54.
  • 6. Bartlett FR, Colgan RM, Carr K, Donovan EM, McNair HA, Locke I, et al. The UK HeartSpare Study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy. Radiother Oncol 2013;108(2):242–7.
  • 7. Bergom C, Currey A, Desai N, Tai A, Strauss JB. Deep Inspiration Breath Hold: Techniques and Advantages for Cardiac Sparing During Breast Cancer Irradiation. Front Oncol 2018;8:87.
  • 8. Swanson T, Grills IS, Ye H, Entwistle A, Teahan M, Letts N, et al. Six-year experience routinely using moderate deep inspiration breath-hold for the reduction of cardiac dose in left-sided breast irradiation for patients with early-stage or locally advanced breast cancer. Am J Clin Oncol 2013;36(1):24–30.
  • 9. Nissen HD, Appelt AL. Improved heart, lung and target dose with deep inspiration breath hold in a large clinical series of breast cancer patients. Radiother Oncol 2013;106(1):28–32.
  • 10.Mohamad O, Shiao J, Zhao B, Roach K, Ramirez E, Vo DT, et al. Deep inspiration breathhold for left-sided breast cancer patients with unfavorable cardiac anatomy requiring internal mammary nodal irradiation. Pract Radiat Oncol 2017;7(6):361–7.
  • 11.NRG. Breast Cancer Atlas. Available at:https:// www.nrgoncology.org/Portals/0/Scientific%20 Program/CIRO/Atlases/BreastCancerAtlas_corr. pdf?ver=2018-04-18-144201-270 Accessed Sep 3, 2020.
  • 12.Sager O, Beyzadeoglu M, Dincoglan F, Oysul K, Kahya Y.E, Gamsiz H. The Role of Active Breathing Control-Moderate Deep Inspiration Breath-Hold (ABC-mDIBH) Usage in non-Mastectomized Leftsided Breast Cancer Radiotherapy: A Dosimetric Evaluation. UHOD.2019, Vol 29, Num 4 Page(s): 147-155.
  • 13.Remouchamps VM, Vicini FA, Sharpe MB, Kestin LL, Martinez AA, Wong JW. Significant reductions in heart and lung doses using deep inspiration breath hold with active breathing control and intensity-modulated radiation therapy for patients treated with locoregional breast irradiation. Int J Radiat Oncol Biol Phys 2003;55(2):392–406.
  • 14.Dincoglan F, Beyzadeoglu M, Sager O, Oysul K, Kahya YE, Gamsiz H, Uysal B, Demiral S, Dirican B, Surenkok S. 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: 10.1700/1248.13792.
  • 15.Péguret N, Ozsahin M, Zeverino M, Belmondo B, Durham AD, Lovis A, et al. Apnea-like suppression of respiratory motion: First evaluation in radiotherapy. Radiother Oncol 2016;118(2):220–6.
  • 16.Goldstein JD, Lawrence YR, Appel S, Landau E, Ben-David MA, Rabin T, et al. Continuous Positive Airway Pressure for Motion Management in Stereotactic Body Radiation Therapy to the Lung: A Controlled Pilot Study. Int J Radiat Oncol Biol Phys 2015;93(2):391–9.
  • 17.Kil WJ, Pham T, Kim K. Heart sparing breast cancer radiotherapy using continuous positive airway pressure (CPAP) and conventional supine tangential fields: an alternative method for patients with limited accessibility to advanced radiotherapy techniques. Acta Oncol 2019 Jan;58(1):105–9.
  • 18.West NS, Parkes MJ, Snowden C, Prentis J, McKenna J, Iqbal MS, et al. Mitigating Respiratory Motion in Radiation Therapy: Rapid, Shallow, Non-invasive Mechanical Ventilation for Internal Thoracic Targets. Int J Radiat Oncol Biol Phys 2019;103(4):1004–10.
  • 19.Chi F, Wu S, Zhou J, Li F, Sun J, Lin Q, et al. Dosimetric comparison of moderate deep inspiration breathhold and free-breathing intensity-modulated radiotherapy for left-sided breast cancer. Cancer Radiother 2015;19(3):180–6.
  • 20.Rice L, Goldsmith C, Green MM, Cleator S, Price PM. An effective deep-inspiration breath-hold radiotherapy technique for left-breast cancer: impact of post-mastectomy treatment, nodal coverage, and dose schedule on organs at risk. Breast Cancer (Dove Med Press) 2017;9:437–46.
  • 21.Bolukbasi Y, Saglam Y, Selek U, Topkan E, Kataria A, Unal Z, Alpan V. Reproducible deep-inspiration breath-hold irradiation with forward intensity-modulated radiotherapy for left-sided breast cancer significantly reduces cardiac radiation exposure compared to inverse intensity-modulated radiotherapy. Tumori 2014;100(2):169–78.
  • 22.Taylor C, Correa C, Duane FK, Aznar MC, Anderson SJ, Bergh J, et al. Estimating the Risks of Breast Cancer Radiotherapy: Evidence From Modern Radiation Doses to the Lungs and Heart and From Previous Randomized Trials. J Clin Oncol 2017;35(15):1641–9.
  • 23.Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 2013;368(11):987–98.
  • 24.Sardaro A, Petruzzelli MF, D’Errico MP, Grimaldi L, Pili G, Portaluri M. Radiation-induced cardiac damage in early left breast cancer patients: risk factors, biological mechanisms, radiobiology, and dosimetric constraints. Radiother Oncol 2012;103(2):133–42.
  • 25.Wiant D, Wentworth S, Liu H, Sintay B. How Important Is a Reproducible Breath Hold for Deep Inspiration Breath Hold Breast Radiation Therapy? Int J Radiat Oncol Biol Phys. 2015 Nov 15;93(4):901–7.
  • 26.Chargari C, Castadot P, Macdermed D, Vandekerkhove C, Bourgois N, Van Houtte P, et al. Internal mammary lymph node irradiation contributes to heart dose in breast cancer. Med Dosim 2010;35(3):163–8.
Türk Onkoloji Dergisi-Cover
  • ISSN: 1300-7467
  • Yayın Aralığı: 4
  • Başlangıç: 2015
  • Yayıncı: Ali Cangül
Sayıdaki Diğer Makaleler

Effects of Oral Health Care Education on the Severity ofOral Mucositis in Pediatric Oncology Patients

Tuba EREN, Remziye SEMERCİ, Melahat AKGÜN KOSTAK, Esra Nur KOCAASLAN, Filiz YILDIZ

Gamma Knife Radiosurgery in the Management of Non-solitary Brain Metastases: A Retrospective Analysis of Survival

Nityanand PANDEY, Manmohan SINGH, Shashank Shanker KALE

Lymphopenia and Radiotherapy for Geriatric CancerPatients in the Reality of COVID-19

Fatma SERT

Epidemiology of Gastrointestinal Cancers in the North of Iran: Results of Mazandaran Population-BasedCancer Registry

Majid YAGHOUBI-ASHRAFI, Akbar HEDAYATIZADEH-OMRAN, Zainab QAZIZADEH, Razieh-Sadat MOUSAVI, Ramin SHEKARRIZ, Mohammad ESLAMI, Ehsan ZABOLI, Ghasem JANBABAEI, Mohsen AARABI, Reza ALIZADEH-NAVAEI, Mahmood MOOSAZADEH

Unusual Localized Non-Hodkin Lymphoma: Left VentricularGiant Mass in a Patient Admitted with Syncope

Hakan GÜNEŞ, Enes ÇELİK, Mehmet KİRİŞÇİ, Bayram ÖZTÜRK, Murat KERKÜTLÜOĞLU

Dosimetric Evaluation of Deep Inspiration Breath-HoldTechnique for Breast Cancer Radiotherapy: A Single-Center Experience

Öztun TEMELLİ, Mehmet DEMİRTAŞ, Berat Tuğrul UĞURLU, Şimay GÜROCAK, Eda KAYA PEPELE, Bahaddin YAPRAK, Hülya GÜLBAŞ, Fatma Aysun ERASLAN

Development of an Attitude Scale for Cancer Screening

Mehmet UYAR, Elif Nur YILDIRIM ÖZTÜRK, Tahir Kemal ŞAHİN

The Role of Radiology in Immunotherapy Response Evaluation

Gülgün ENGİN

The Use of High-Volume Endorectal Balloon is Effective to Reduce Doses of Rectum and Bladder in ProstateCancer Patients Treated with Linac-Based StereotacticBody Radiotherapy

Mete GÜNDOĞ, Hatice BAŞARAN, Okan ORHAN, Kadir YARAY, Tarkan AKSÖZEN, Esin KİRAZ, Celalettin EROĞLU

Cost-Effectiveness Analysis of Leuprorelin Acetate Atrigelin the Treatment of Prostate Cancer

Gökhan ÖZYİĞİT, Fadıl AKYOL