Volumetric modulated arc therapy applied to synchronous bilateral breast cancer radiotherapy: dosimetric study on deep inspiration breath hold versus free breathing set up

2018 ◽  
Vol 4 (4) ◽  
pp. 045007 ◽  
Author(s):  
D Gaudino ◽  
S Cima ◽  
M Frapolli ◽  
D Daniele ◽  
B Muoio ◽  
...  
Keyword(s):  
Volumetric Modulated Arc Therapy ◽  
Bilateral Breast Cancer ◽  
Free Breathing ◽  
Breath Hold ◽  
Deep Inspiration Breath Hold ◽  
Breast Cancer Radiotherapy ◽  
Synchronous Bilateral Breast Cancer ◽  
Arc Therapy ◽  
Dosimetric Study ◽  
Set Up

Is it advantageous to use deep inspiration breath hold (DIBH) over free breathing for FAST-Forward dose fractionation scheme in treating carcinoma of left-sided breast? A dosimetric study

2021 ◽  
pp. 1-8
Author(s):  
Jagadheeskumar Nagaraj ◽  
Anu Radha Chandrasekaran
Keyword(s):  
Volumetric Modulated Arc Therapy ◽  
Free Breathing ◽  
Planning System ◽  
Dose Fractionation ◽  
Treatment Planning System ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Computed Tomography Images ◽  
Arc Therapy

Abstract Aim: To study the effect of deep inspiration breath hold (DIBH) on Fast-Forward trial for left-sided breast radiotherapy dosimetrically using tangential field-in-field (FiF), flattening filtered volumetric-modulated arc therapy (FF-VMAT) and flattening filter free volumetric-modulated arc therapy (FFF-VMAT) in comparison with free breathing (FB). Methods: Computed tomography images were acquired on 15 patients with carcinoma of left breast in FB and DIBH. Planning target volume (PTV) and organs at risk were contoured on both image sets. Dose of 26 Gy in five daily fractions was prescribed to PTV. FiF, FF-VMAT and FFF-VMAT plans were created in treatment planning system on both FB and DIBH. PTV V95%, V107%, D0·1 cc, CI and HI, heart V1·5 Gy, V7 Gy, lung left V8 Gy, monitor units (MU) and beam ON time were used for evaluation. Different technique analysis in same breathing condition and FB versus DIBH for same planning technique were performed. Results: Mean of all 15 patients was reported as mean ± 1 standard deviation. PTV V95% was 97·55 ± 0·10 (FiF), 95·75 ± 0·66 (FF-VMAT) and 96·15 ± 0·46 (FFF-VMAT) in FB while 97·34 ± 0·50 (FiF), 96·03 ± 0·71 (FF-VMAT) and 95·86 ± 0·63 (FFF-VMAT) in DIBH. Heart V7 Gy was 8·53 ± 4·26 (FiF), 8·86 ± 2·20 (FF-VMAT) and 9·27 ± 2·46 (FFF-VMAT) in FB while 6·30 ± 2·98 (FiF), 5·23 ± 2·20 (FF-VMAT) and 4·68 ± 2·01 (FFF-VMAT) in DIBH. p-value of heart V7 Gy between FB and DIBH was 0·278 (FiF), 0·009 (FF-VMAT) and 0·003 (FFF-VMAT). Beam ON time for FFF-VMAT was reduced by 65% (FF-VMAT) and 11% (FiF). Conclusion: Conformal dose to PTV was achieved better with VMAT plans. FFF-VMAT was delivered in less time compared to FF-VMAT and FiF for 26 Gy in five fractions. Heart dose can be significantly minimised with DIBH for VMAT plans.

scholarly journals Od 2D do DIBH, przegląd technik radioterapeutycznych stosowanych w napromienianiu nowotworów piersi From 2D to DIBH, review of radiotherapeutic techniques related to irradiation of breast cancer

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Magdalena Charmacińska ◽  
Sara Styś ◽  
Olga Bąk ◽  
Weronika Kijeska ◽  
Agnieszka Skrobała
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Target Volume ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Intensity Modulated ◽  
Arc Therapy

Nowotwór piersi jest to nowotwór złośliwy powstający z komórek gruczołu piersiowego, który rozwija się miejscowo w piersi oraz daje przerzuty do węzłów chłonnych i narządów wewnętrznych (płuc, wątroby, kości i mózgu). Ponad 23% zachorowań na nowotwory kobiet w Polsce, jak i na świecie stanowią nowotwory piersi. Na przestrzeni ostatnich lat techniki napromieniania nowotworów piersi ulegają ciągłemu rozwojowi. Celem pracy było poglądowe przedstawienie technik radioterapeutycznych stosowanych w napromienianiu nowotworów piersi, od dwuwymiarowej 2D techniki statycznej poprzez techniki dynamiczne (IMRT technika z modulacją intensywnością dawki (ang. intensity modulated radiation therapy), VMAT technika obrotowa z modulacją intensywności dawki (ang. volumetric modulated arc therapy), aż do techniki DIBH techniki napromieniania na głębokim wstrzymanym wdechu (ang. deep inspiration breath hold). W pracy skupiono się na przedstawieniu realizacji omawianych technik i opisie jak dana technika wpływa na rozkład dawki w planowanej objętości do napromieniania PTV (ang. Planning Target Volume) oraz na dawki w narządach krytycznych w radioterapii nowotworów piersi.

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.

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