REM Radioterapia srl, Viagrande, Italy;
Radiation Oncology Unit - Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy.
Anticancer Res. 2021 Mar;41(3):1529-1538. doi: 10.21873/anticanres.14912.
BACKGROUND/AIM: This study aimed to analyze the dosimetric gain of the deep-inspiration-breath-hold (DIBH) technique over the free-breathing (FB) one in left breast cancer (LBC) 3D-conformal-radiotherapy (3D-CRT), and simultaneously investigate the anatomical parameters related to heart RT-exposure.
Treatment plans were generated in both DIBH and FB scenarios for 116 LBC patients monitored by the Varian RPM™ respiratory gating system for delivery of conventional or moderately hypofractionated schedules (±sequential boost). For comparison, we considered cardiac and ipsilateral lung doses and volumes.
A significant reduction of cardiac and pulmonary doses using DIBH technique was achieved compared to FB plans. Larger clinical target volumes generally need longer distance between medial and lateral entrances of tangent fields at body surface, thus conditioning a worse heart RT-exposure.
The DIBH technique reduces cardiac and pulmonary doses for LBC patients. Through easily detectable anatomical parameters, it is possible to predict which patients benefit most from DIBH-RT.
背景/目的：本研究旨在分析深吸气屏气（DIBH）技术在左侧乳腺癌（LBC）三维适形放疗（3D-CRT）中相对于自由呼吸（FB）的剂量增益，并同时研究与心脏 RT 暴露相关的解剖参数。
为 116 例通过瓦里安 RPM™呼吸门控系统监测的 LBC 患者生成了 DIBH 和 FB 场景下的治疗计划，以实施常规或中度超分割方案（±序贯加量）。为了进行比较，我们考虑了心脏和同侧肺剂量和体积。
与 FB 计划相比，DIBH 技术显著降低了心脏和肺部的剂量。较大的临床靶区通常需要在体表面切线野的内侧和外侧入口之间有更长的距离，从而导致心脏 RT 暴露更差。
DIBH 技术降低了 LBC 患者的心脏和肺部剂量。通过易于检测的解剖参数，可以预测哪些患者从 DIBH-RT 中获益最大。
