scholarly journals 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

2017 ◽  
Vol Volume 9 ◽  
pp. 437-446 ◽  
Author(s):  
Lynsey Rice ◽  
Christy Goldsmith ◽  
Melanie ML Green ◽  
Susan Cleator ◽  
Patricia M Price
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Organs At Risk ◽  
Dose Schedule ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold

scholarly journals Analysis Of Dose At 3D-Crt And Imrt Techniques In Left Breast Cancer Case With Hypofractionation Using Deep Inspiration Breath-Hold (Dibh)

2021 ◽  
Author(s):  
Samsun - ◽  
Muhammad Arif Arif ◽  
Gregorius Septayudha Septayudha
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Organs At Risk ◽  
Left Breast ◽  
Breath Hold ◽  
Tolerance Limits ◽  
Deep Inspiration Breath Hold ◽  
Organ At Risk ◽  
The Difference ◽  
3D Crt

Abstract In terms of breast cancer radiation treatment, it has radiation using the 3D-Conformal Radiotherapy (3D-CRT) technique and the continuation of the 3D-CRT technique, namely the Intensity Modulated Radiation Therapy (IMRT) technique. This study aims to evaluate the dosage aspects of PTV and OAR between the 3D-CRT and IMRT techniques in cases of left breast cancer with hypofractionation using the Deep Inspiration Breath Hold (DIBH) method using the Conformity Index (CI) and Homogeneity Index (H.I.) and H.I. organ at risk uses tolerance limits. This type of research is comparative quantitative with ten samples with primary data conducted at Siloam T.B. Hospital. Simatupang from November 2019 to April 2020. The research was carried out in the form of radiation planning with 3D-CRT techniques and IMRT techniques, and the results of planning both techniques were evaluated between 3D-CRT techniques and IMRT techniques through PTV evaluations using CI and H.I. values. Furthermore, the organs at risk use tolerance limits on each organ. The results showed the assessment between 3D-CRT and IMRT on PTV and organs at risk received different doses. The PTV shows the CI value, which is almost the same as the difference of 0.034, and there is a slight difference in H.I. with an average value in the IMRT technique of 0.07 and 3D-CRT of 0.11, and it can be seen that the IMRT is slightly superior because the excellent H.I. value is the closest to 0. Then at the dose of organ at risk received by the sample, the 3D-CRT technique is slightly superior by obtaining a lower dose that obtains the difference in the heart by 0.53%, lung by 3.46%, spinal cord by 6.51 Gy, esophagus at 4.5 Gy, and larynx at 5.18 Gy.

The Advantages of Active Breathing Coordinator Device During Left-Sided Breast Cancer Radiation Therapy: A Dosimetric Comparison Study

2020 ◽  
Author(s):  
Nadia Pasinetti ◽  
Lilia Bardoscia ◽  
Luigi Spiazzi ◽  
Barbara Ghedi ◽  
Sara Pedretti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Side Effects ◽  
Organs At Risk ◽  
Left Lung ◽  
Normal Tissue Complication Probability ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration Breath Hold ◽  
Dose Volume Histograms

Abstract Background: Radiotherapy (RT) improves local control and survival in breast cancer (BC) patients. However, risk of heart and lung side effects after post-operative left breast RT for breast cancer remain despite technological and technical RT advances. In a retrospective cohort we investigated if Active Breathing Coordinator (ABC) device can reduce risk of cardiopulmonary morbidity.Methods: we performed two different dosimetric analyses by Normal Tissue Complication Probability (NTCP) and Bio-Dose-Volume Histograms (Bio-DVH) in order to determine whether left breast RT using moderating deep inspiration breath-hold (mDIBH) with the Active Breathing Coordinator (ABC) device, may significantly reduce heart, left anterior descending coronary artery (LADCA) and lung radiation exposure during left breast RT performed with 3d-CRT technique.Results: Several dosimetric parameters were used in the present study to compare the treatment plans generated by FB and mDIBH images of sixty-nine consecutive patients treated between May 2012 and April 2016 at the Istituto del Radio Radiation Oncology Dept. All data derived by Bio-DVH and the heart NTCP calculation showed that ABC led to significant sparing of organs at risk compared with FB, expecially for the heart and LADCA. We also showed that the mDIBH technique significantly reduced left lung dose: in fact, through inflation, only low density lung tissue remains within the tangential field, thus avoiding its deterioration.Conclusions: Use of mDIBH gives a real advantage on breast cancer RT by reducing the radiation to the organs at risk (OARs) and consequently, the risk of cardiac and pulmonary late side effects.

scholarly journals Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bruno Speleers ◽  
Max Schoepen ◽  
Francesca Belosi ◽  
Vincent Vakaet ◽  
Wilfried De Neve ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Lymph Node ◽  
Organs At Risk ◽  
Lymph Node Status ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Proton Radiotherapy ◽  
Regional Lymph Nodes ◽  
Deep Inspiration Breath Hold

AbstractWe report on a comparative dosimetrical study between deep inspiration breath hold (DIBH) and shallow breathing (SB) in prone crawl position for photon and proton radiotherapy of whole breast (WB) and locoregional lymph node regions, including the internal mammary chain (LN_MI). We investigate the dosimetrical effects of DIBH in prone crawl position on organs-at-risk for both photon and proton plans. For each modality, we further estimate the effects of lung and heart doses on the mortality risks of different risk profiles of patients. Thirty-one patients with invasive carcinoma of the left breast and pathologically confirmed positive lymph node status were included in this study. DIBH significantly decreased dose to heart for photon and proton radiotherapy. DIBH also decreased lung doses for photons, while increased lung doses were observed using protons because the retracting heart is displaced by low-density lung tissue. For other organs-at-risk, DIBH resulted in significant dose reductions using photons while minor differences in dose deposition between DIBH and SB were observed using protons. In patients with high risks for cardiac and lung cancer mortality, average thirty-year mortality rates from radiotherapy-related cardiac injury and lung cancer were estimated at 3.12% (photon DIBH), 4.03% (photon SB), 1.80% (proton DIBH) and 1.66% (proton SB). The radiation-related mortality risk could not outweigh the ~ 8% disease-specific survival benefit of WB + LN_MI radiotherapy in any of the assessed treatments.

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.

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.

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