Evaluating Radiation Dose to the Heart With Left Whole Breast Radiation Therapy in Prone, Supine Breath-Hold, and Supine Free-Breathing Positions

2013 ◽  
Vol 87 (2) ◽  
pp. S229
Author(s):  
B.A. Perez ◽  
P.R. Patel ◽  
S. Yoo ◽  
L. O'Neill ◽  
K.P. Livengood ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Dose ◽  
Free Breathing ◽  
Breath Hold

Deep-inspiration breath hold radiotherapy in patients with left-sided breast cancer after partial mastectomy

2021 ◽  
Vol 100 (4) ◽  
Keyword(s):  
Breast Cancer ◽  
Radiation Dose ◽  
Organs At Risk ◽  
Left Lung ◽  
Free Breathing ◽  
Partial Mastectomy ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Dose Volume Histograms

Introduction: The purpose of this study was to compare the radiation dose to organs at risk for deep-inspiration breath hold (DIBH) and free-breathing (FB) radiotherapy in patients with lef-sided breast cancer undergoing adjuvant radiotherapy after partial mastectomy. Methods: One hundred patients with left-sided breast cancer underwent DIBH and FB planning computed tomography scans, and the 2 techniques were compared. Dose-volume histograms were analyzed for heart, left anterior descending coronary artery (LAD), and left lung. Results: Radiation dose to heart, LAD, and left lung was significantly lower for DIBH than for free breathing plans. The median mean heart dose for DIBH technique in comparison with FB was 1.21 Gy, and 3.22 Gy respectively; for LAD, 4.67 versus 24.71 Gy; and for left lung 8.32 Gy versus 9.99 Gy. Conclusion: DIBH is an effective technique to reduce cardiac and lung radiation exposure.

Deep Inspiration Breath Hold Radiation Therapy Reduces Heart Radiation Dose in Gastric Radiation Therapy

2014 ◽  
Vol 90 (1) ◽  
pp. S834-S835
Author(s):  
M. Hojgaard ◽  
M.C. Aznar ◽  
D.A. Schut ◽  
L. Specht ◽  
A.N. Pedersen ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Dose ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold

scholarly journals Quantification of an External Motion Surrogate for Quality Assurance in Lung Cancer Radiation Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Jens Wölfelschneider ◽  
Tobias Brandt ◽  
Sebastian Lettmaier ◽  
Rainer Fietkau ◽  
Christoph Bert
Keyword(s):  
Quality Assurance ◽  
Radiation Therapy ◽  
Global Minimum ◽  
Tumor Volume ◽  
Lung Tumor ◽  
Free Breathing ◽  
Breath Hold ◽  
Target Volumes ◽  
Posterior Direction ◽  
The Stability

The purpose of this work was to validate the stability of the end exhale position in deep expiration breath hold (DEBH) technique for quality assurance in stereotactic lung tumor radiation therapy. Furthermore, a motion analysis was performed for 20 patients to evaluate breathing periods and baseline drifts based on an external surrogate. This trajectory was detected using stereo infrared (IR) cameras and reflective body markers. The respiratory waveform showed large interpatient differences in the end exhale position during irradiation up to 18.8 mm compared to the global minimum. This position depends significantly on the tumor volume. Also the baseline drifts, which occur mostly in posterior direction, are affected by the tumor size. Breathing periods, which depend mostly on the patient age, were in a range between 2.4 s and 7.0 s. Fifteen out of 20 patients, who showed a reproducible end exhale position with a deviation of less than 5 mm, might benefit from DEBH due to smaller planning target volumes (PTV) compared to free breathing irradiation and hence sparing of healthy tissue. Patients with larger uncertainties should be treated with more complex motion compensation techniques.

Deep inspirational breath hold to reduce cardiac dose in left-sided breast radiotherapy

2017 ◽  
Vol 16 (3) ◽  
pp. 251-257 ◽  
Author(s):  
Camarie Welgemoed ◽  
Jonathan Rogers ◽  
Patti McNaught ◽  
Susan Cleator ◽  
Pippa Riddle ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Free Breathing ◽  
Good Method ◽  
Breath Hold ◽  
Treatment Area ◽  
Breast Radiotherapy ◽  
Deep Inspiration Breath Hold ◽  
Heart Dose ◽  
Set Up ◽  
Mean Heart Dose

AbstractBackgroundDuring left-sided breast radiotherapy, the heart is often exposed to radiation dose. Shielding can be utilised to reduce heart exposure, but compromises the dose delivered to the breast tissue and, in a proportion of patients, to the tumour bed. Deep inspiration breath hold (DIBH) can be used as a technique to move the heart away from the treatment area and thus reduce heart dose. This study examines the efficacy of the Elekta Active Breathing Coordinator (ABC), a DIBH method, in reducing heart dose.Materials and methodsIn total, 12 patients receiving radiotherapy to the left breast were planned for treatment with both a free-breathing (FB) and an ABC scan. The dose volume histogram data for the plans was analysed with respect to heart V13, V5 Gy, mean heart dose and ipsilateral lung V18 Gy. Tumour bed D98%, threshold lung volume in breath hold (BH) and the maximum BH time for each patient was also measured. Patients then received their radiotherapy treatment using the ABC plan and the systematic error in the craniocaudal, lateral and vertical axes was assessed using orthogonal imaging.ResultsThe median heart V13 Gy for FB and DIBH patients was 3% (range, 0·85–11·28) and 0% (range, 0–1·56), respectively, with a mean heart dose of 2·62 Gy (range, 1·21–4·93) in FB and 1·51 Gy (range, 1·17–2·22) in ABC. The median lung V18 Gy was 8·7% (3·08–14·87) in FB plans and 9% (4·88–12·82) in ABC plans. The mean systematic set-up errors in all three planes were within the departmental set-up tolerance of 5 mm for both techniques. Median FB tumour bed D98% was 97·4% (92·8–99·5) and 97·5% (97·3–98·5) for ABC.ConclusionABC represents a good method of reducing radiation dose to the heart while not compromising on dose to the tumour bed, and it has a clear advantage over FB radiotherapy in reducing the risk of cardiac toxicity. It is tolerated well by patients and does not produce any difficulties in patient positioning.

scholarly journals Reducing Cardiac Radiation Dose From Breast Cancer Radiation Therapy With Breath Hold Training and Cognitive Behavioral Therapy

2020 ◽  
Vol 29 (3) ◽  
pp. 135-148 ◽  
Author(s):  
Nina A. Mayr ◽  
Kai J. Borm ◽  
Alan M. Kalet ◽  
Landon S. Wootton ◽  
Alexandra L. Chadderdon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Radiation Dose ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Breath Hold

scholarly journals Comparative analysis of dose distribution to critical organs in radiation therapy of left breast cancer with respiratory synchronization

2021 ◽  
Vol 60 (2) ◽  
pp. 27-31
Author(s):  
D. A. Yussupova ◽  
A. D. Savkhatova ◽  
M. D. Zekebayev ◽  
A. K. Quatbek
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Left Lung ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Radiation Load ◽  
Deep Inspiration Breath Hold ◽  
Study Results ◽  
Respiratory Synchronization

Relevance: Breast cancer is one of the most common oncological diseases. Today, it leads among female cancers. Patients with left breast cancer undergoing radiation therapy have a considerable risk of developing cardiovascular diseases caused by ionizing radiation. Various methods are introduced to reduce the radiation load to critical organs to ensure compliance with the main radiation therapy principle. One of these methods is radiation therapy with synchronized breathing, including deep inspiration breath-hold (DIBH). DIBH can significantly reduce the dose load to the heart and the left lung. The study aimed to compare the radiation load to the heart and the left lung during radiation therapy for left breast cancer with free breathing and respiratory synchronization. Results: During radiation therapy with synchronized breathing, the average radiation load to the heart is 1.7 times lower and to the left lung – 1.26 times lower compared to radiation therapy with free breathing. Conclusion: The study results confirm that respiratory synchronization in radiation therapy for left breast cancer reduces the dose to the heart and the left lung.

Degree of reduction in normal liver complication probability from free-breathing to breath-hold liver SBRT: A dose-escalation strategy using radiation dose-volume effect

2021 ◽  
Author(s):  
Deepak Thaper ◽  
Hanuman Yadav ◽  
Deepti Sharma ◽  
Rose Kamal ◽  
Gaganpreet Singh ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Dose Escalation ◽  
Normal Liver ◽  
Free Breathing ◽  
Patient Specific ◽  
Breath Hold ◽  
Degree Of Reduction ◽  
Dose Volume ◽  
Liver Sbrt ◽  
Liver Complication

Abstract Introduction: This study aimed to analyze the degree of reduction in normal liver complication probability (NTCP) from free-breathing (FB) to breath-hold (BH) liver SBRT. The effect of the radiation dose-volume on the mean liver dose (MLD) was also analyzed due to dose prescription, normal liver volume (NLV), and PTV. Materials and Methods: Thirty-three stereotactic body radiation therapy (SBRT) cases of hepatocellular carcinoma were selected, retrospectively. For FB, the treatments were planned on average intensity projection scan (CTavg), and patient-specific internal target volume (ITV) margins were applied. To simulate the BH treatment, computed tomography (CT) scan correspond to the 40% - 50% of the respiratory cycle (CT40%-50%) was chosen, and an appropriate intrafraction margin of 2 mm, 1.5 mm, and 1.5 mm were given in craniocaudal (CC), superior-inferior (SI), and lateral direction to generate the final iGTV. As per RTOG 1112, all organs at risk (OAR’s) were considered during the optimization of treatment plans. NTCP was calculated using LKB fractionated model. Multivariate regression analysis was performed to see the effect of EQD2Gy, NLV, and PTV on MLD2Gy. Results: A significant dosimetric difference was observed in the normal liver (liver-ITV/iGTV). A reduction of 1.7% in NTCP was observed from FB to BH technique. The leverage of dose escalation is more in BH because MLD2Gy corresponds to 5%, 10%, 20%, and 50% NTCP was 0.099 Gy, 0.41 Gy, 1.21 Gy, and 3.432 Gy more in BH as compared to FB technique. In MVRA, the major factor which was attributed to a change in MLD2Gy is EQD2Gy. Conclusion: From FB to BH technique, a significant reduction in NTCP was observed. The dose prescription is a major factor attributed to the change in MLD2Gy. Advances in knowledge: If feasible, prefer BH treatment either for tumor dose escalation or for the reduction in NTCP.

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