172. Predictors of cardiac dose reduction achieved with deep inspiration breath hold technique over free breathing technique in left breast radiotherapy

2018 ◽  
Vol 56 ◽  
pp. 169-170
Author(s):  
M. Maddalo ◽  
G. Benecchi ◽  
C. Grondelli ◽  
E. Calabri ◽  
R. Rossi ◽  
...  
Keyword(s):  
Dose Reduction ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Breast Radiotherapy ◽  
Deep Inspiration Breath Hold ◽  
Cardiac Dose

Dosimetric advantage of Deep Inspiration Breath Hold in left breast radiotherapy: comparative analysis with free breathing

2017 ◽  
Vol 72 ◽  
pp. S26
Author(s):  
A.S. Rolo ◽  
S. Germano ◽  
F. Mascarenhas ◽  
T. Almeida ◽  
C. Miguel ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Breast Radiotherapy ◽  
Deep Inspiration Breath Hold

scholarly journals EP-1316: Prone breast radiotherapy in prone: free breathing, deep inspiration breath hold and inspiration gating

2015 ◽  
Vol 115 ◽  
pp. S710
Author(s):  
M. Swimberge ◽  
V. Remouchamps ◽  
L. Veldeman ◽  
T. Mulliez ◽  
B. Speelers ◽  
...  
Keyword(s):  
Free Breathing ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Breast Radiotherapy ◽  
Deep Inspiration Breath Hold

Lợi ích xạ trị ung thư vú trái phối hợp hít sâu nín thở và hệ thống quản lý bề mặt quang học của máy Truebeam tại Bệnh viện Ung bướu Thành phố Hồ Chí Minh

2021 ◽  
Author(s):  
Anh Phuong Le
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Management System ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Optical Surface ◽  
Deep Inspiration Breath Hold ◽  
Cardiac Dose ◽  
Set Up

TÓM TẮT Đối với ung thư vú (UTV) xạ trị là điều trị bổ túc cần thiết giúp giảm tái phát tại chỗ tại vùng, gia tăng sống còn. Tuy nhiên, xạ trị có tác dụng phụ lên tim mạch nhất là với UTV trái. Nhiều nghiên cứu đã chứng minh biến chứng và tử vong do tim mạch tăng tỉ lệ thuận với liều trung bình lên tim. Các kỹ thuật xạ trị mới trong xạ trị ung thư vú trái giúp tối ưu hóa liều vào thể tích xạ và bảo vệ tốt hơn cơ quan lành, càng đòi hỏi độ chính xác cao khi đặt bệnh. Các sai số do thiết bị hoặc đặt bệnh sẽ dẫn đến nguy cơ quá liều dung nạp hoặc thiếu liều và có nguy cơ tái phát. Vì vậy, xạ trị đòi hỏi sự chính xác cao trong suốt quá trình từ mô phỏng đến lập kế hoạch và tiến hành xạ trị. Xạ trị ung thư vú trái phối hợp hít sâu nín thở (DIBH - Deep Inspiration Breath - hold) và hệ thống quản lý bề mặt quang học (OSMS - Optical Surface Management System) làm cho tim di chuyển ra xa hơn khỏi vú, thành ngực trong quá trình xạ trị, giúp giảm liều tim một cách rõ rệt, vẫn đảm bảo được liều xạ lên thể tích đích. Ưu điểm của OSMS ngoài áp dụng cho đặt bệnh nhanh không cần xăm dấu trên da còn giám sát thời gian thực trong toàn bộ quá trình điều trị. Khi nhịp thở của bệnh nhân vượt quá một ngưỡng nhất định (0,3cm) chùm tia bức xạ sẽ bị tắt để ngăn ngừa độc tính. Do đó, hiểu và nắm rõ lợi ích quy trình đặt bệnh giúp đạt mục tiêu điều trị đồng thời giảm thời gian đặt bệnh để người bệnh có tâm lý thoải mái hơn, giảm áp lực về số lượng bệnh, nhất là đối với các trung tâm xạ trị lớn. ABSTRACT BENEFITS OF LEFT BREAST CANCER RADIATION COMBINATION OF DEEP INSPIRATION BREATH - HOLD AND OPTICAL SURFACE MANAGEMENT SYSTEM OF TRUEBEAM MACHINE AT CANCER HOSPITAL HO CHI MINH CITY Background: For breast cancer, radiation therapy is an essential adjuvant treatment to help reduce local recurrence and increase survival. However, radiation therapy has adverse effects on the cardiovascular systemespecially for left breast cancer. Several studies have demonstrated that cardiovascular morbidity and mortality increase in proportion to the mean cardiac dose. New radiotherapy techniques in radiation therapy for left breast cancer help optimize dose to radiation volume and better protect healthy organs, which requires high accuracy when patient set - up. Errors due to equipment or patient set - up will lead to the risk of overdosage or underdosage and risk of relapse. Therefore, radiation therapy requires high precision throughout the process from simulation to planning and conducting radiation therapy. Radiation therapy for left breast cancer combined with Deep Inspiration Breath - hold (DIBH) and Optical Surface Management System (OSMS)causes the heart to move further away from the breast and chest wall during radiation therapy, helping to reduce the cardiac dose significantly, still ensuring the radiation dose to the target volume. The advantage of OSMS is that in addition to being applied for fastpatient set - up, without tattooing on the skin, it also provides real - time monitoring during the entire treatment process. When the patient’s breathing rate exceeds a certain threshold (0,3cm) the radiation beam is turned off to prevent toxicity. Therefore, understanding and understanding the benefits of patient set - up helps to achieve treatment goals, while reducing patient set - up time for more comfort, reducing pressure on the number of patients, especially for patients large radiotherapy center. Keyword: Radiation therapy for left breast cancer, Deep Inspiration Breath - hold, Optical Surface Management System, cardiovascular risk.

scholarly journals Dosimetric Considerations in Respiratory-Gated Deep Inspiration Breath-Hold for Left Breast Irradiation

2016 ◽  
Vol 16 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Steve Walston ◽  
Allison M. Quick ◽  
Karla Kuhn ◽  
Yi Rong
Keyword(s):  
Chest Wall ◽  
Lung Volume ◽  
Left Lung ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Lung Dose ◽  
Deep Inspiration Breath Hold ◽  
Heart Dose

Purpose: To present our clinical workflow of incorporating AlignRT for left breast deep inspiration breath-hold treatments and the dosimetric considerations with the deep inspiration breath-hold protocol. Material and Methods: Patients with stage I to III left-sided breast cancer who underwent lumpectomy or mastectomy were considered candidates for deep inspiration breath-hold technique for their external beam radiation therapy. Treatment plans were created on both free-breathing and deep inspiration breath-hold computed tomography for each patient to determine whether deep inspiration breath-hold was beneficial based on dosimetric comparison. The AlignRT system was used for patient setup and monitoring. Dosimetric measurements and their correlation with chest wall excursion and increase in left lung volume were studied for free-breathing and deep inspiration breath-hold plans. Results: Deep inspiration breath-hold plans had significantly increased chest wall excursion when compared with free breathing. This change in geometry resulted in reduced mean and maximum heart dose but did not impact lung V20 or mean dose. The correlation between chest wall excursion and absolute reduction in heart or lung dose was found to be nonsignificant, but correlation between left lung volume and heart dose showed a linear association. It was also identified that higher levels of chest wall excursion may paradoxically increase heart or lung dose. Conclusion: Reduction in heart dose can be achieved for many left-sided breast and chest wall patients using deep inspiration breath-hold. Chest wall excursion as well as left lung volume did not correlate with reduction in heart dose, and it remains to be determined what metric will provide the most optimal and reliable dosimetric advantage.

Evaluation of an in-house self-held respiration monitoring device for deep inspiration breath hold techniques for radiotherapy of patients with cancer of the left breast

2019 ◽  
Vol 19 (2) ◽  
pp. 122-126
Author(s):  
Yuen Yan Chan ◽  
Ki Man Ku ◽  
Yin Ping Ng ◽  
Siu Ki Ben Yu ◽  
Chi Wah Tony Kong ◽  
...  
Keyword(s):  
Maximum Dose ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Monitoring Device ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Respiration Monitoring ◽  
Heart Dose ◽  
Mean Error

AbstractBackground:An in-house self-held respiration monitoring device (SHRMD) was developed for providing deep inspiration breath hold (DIBH) radiotherapy. The use of SHRMD is evaluated in terms of reproducibility, stability and heart dose reduction.Methods and materials:Sixteen patients receiving radiotherapy of left breast cancer were planned for treatment with both a free breathing (FB) scan and a DIBH scan. Both FB and DIBH plans were generated for comparison of the heart, left anterior descending (LAD) artery and lung dose. All patients received their treatments with DIBH using SHRMD. Megavoltage cine images were acquired during treatments for evaluating the reproducibility and stability of treatment position using SHRMD.Results:Compared with FB plans, the maximum dose to the heart by DIBH technique with SHRMD was reduced by 29·9 ± 15·6%; and the maximum dose of the LAD artery was reduced by 41·6 ± 18·3%. The inter-fractional overall mean error was 0·01 cm and the intra-fractional overall mean error was 0·04 cm.Conclusion:This study demonstrated the potential benefits of using the SHRMD for DIBH to reduce the heart and LAD dose. The patients were able to perform stable and reproducible DIBHs.

scholarly journals Selection of patients with left breast cancer for IMRT with deep inspiration breath-hold technique

2020 ◽  
Vol 61 (3) ◽  
pp. 431-439 ◽  
Author(s):  
Chih-Shen CHANG ◽  
Chia-Hsin CHEN ◽  
Kuo-Chi LIU ◽  
Chia-Sheng HO ◽  
Miao-Fen CHEN
Keyword(s):  
Breast Cancer ◽  
Lung Volume ◽  
Free Breathing ◽  
Target Volume ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Total Lung Volume ◽  
The Difference

Abstract The deep inspiration breath-hold (DIBH) technique has been utilized to reduce the cardiac dose in left-sided breast cancer (BC) patients undergoing radiotherapy. Further investigation of the parameters for selecting which patients will benefit most from DIBH is essential. We performed dosimetric comparisons for 21 patients with left-sided BC who had both computed tomography (CT)-based free-breathing (FB) and DIBH plans. The doses to the heart and left anterior descending artery (LAD) and any reduction due to the DIBH technique were analysed. Based on CTFB plans, dosimetric analysis revealed that the irradiation doses to the heart and LAD were significantly correlated with the target volume, the ipsilateral lung volume (ILV) and the total lung volume (TLV). When patients had an ILV ≥ 950 cm3 or a TLV ≥ 2200 cm3, the irradiation doses to the heart and LAD were significantly decreased. Furthermore, the reduction in the mean heart dose (MHD) was correlated to the difference in lung volume between FB and DIBH. The difference in ILV between DIBH and FB of 1.8 indicated that the patients obtained more benefit from the DIBH technique. The data suggest that lung volume (ILV and TLV) measured on a CT-simulation scan and the difference between FB and DIBH could be utilized to help select patients for DIBH.

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