scholarly journals Quantifying the Effects of Combining Deep Inspiration Breath Hold (DIBH) With Volumetric Modulated Arc Therapy (VMAT) in Breast Cancer Patients Receiving Regional Nodal Irradiation (RNI)

2016 ◽  
Vol 96 (2) ◽  
pp. E681
Author(s):  
V.A. Dumane ◽  
K. Saksornchai ◽  
Y. Zhou ◽  
L. Hong ◽  
A.Y. Ho
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Volumetric Modulated Arc Therapy ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Breast Cancer Patients ◽  
Regional Nodal Irradiation ◽  
Deep Inspiration Breath Hold ◽  
Arc Therapy

scholarly journals Clinical Implications of Geometric and Dosimetric Uncertainties of Inter- and Intra-Fractional Movement during Volumetric Modulated Arc Therapy for Breast Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1651
Author(s):  
Jason Joon Bock Lee ◽  
Ik Jae Lee ◽  
Yeonho Choi ◽  
Mi Jin Jeon ◽  
Il Hun Jung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Volumetric Modulated Arc Therapy ◽  
Fold Increase ◽  
Cone Beam ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Deep Inspiration Breath Hold ◽  
Arc Therapy ◽  
Pre Treatment

With the introduction of modern sophisticated radiotherapy (RT) techniques, the significance of accuracy has increased considerably. This study evaluated the necessity of pre-treatment and intra-fractional cone-beam computed tomography (CBCT) by analyzing inter- and intra-fractional CBCT images of breast cancer patients receiving RT. From 57 patients, 1206 pre-treatment CBCT and 1067 intra-fractional CBCT images were collected. Geometric movements of patients were measured quantitively in both inter- and intra-fractional CBCT, and changes in dosimetric parameters were evaluated in selected patients with extreme intra-fractional movement. For right-sided breast cancer patients, left-sided breast cancer patients treated using deep-inspiration breath hold (DIBH), and left-sided breast cancer patients treated using continuous positive airway pressure (CPAP), median inter-fractional deviations were 0.53 (range 0.06–2.98) cm, 0.66 (range 0.08–4.41) cm, and 0.69 (range 0.04–3.80) cm, and median intra-fractional deviations were 0.14 (range 0.00–0.62) cm, 0.23 (range 0.02–0.96) cm, and 0.24 (0.00–1.15) cm, respectively. Modified plans reflecting large changes in intra-fractional position in 10 selected cases revealed insufficient target coverage in seven cases and more than 20-fold increase in the volume of heart receiving at least 25 Gy in two cases. Intra-fractional verification, as well as pre-treatment verification, might be considered in patients using DIBH or CPAP.

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