OBJECTIVE

To analyse the dosimetric benefit achieved with Deep inspiratory breath hold (DIBH) for left sided breast irradiation and to identify the factors impacting it.

METHODS

Between 1st January'2023 to 31st December' 2023, 100 consecutive patients with left sided breast cancer receiving adjuvant radiotherapy and fulfilling the inclusion/exclusion criteria were enrolled in a prospective study conducted at Rajiv Gandhi Cancer Institute and Research Centre, New Delhi. Two radiotherapy plans (DIBH/Free breathing (FB)) were generated and evaluated for each patient. Plans were evaluated using dose-volume histogram (DVH). Anatomical and treatment parameters predicting cardiac sparing were generated.

RESULT

DIBH led to improvement in dosimetry for lung and cardiac structures for all group of patients. Breathhold technique showed a significant increase in the circumference of the chest, separation and heart height. An approximately 45% increase in ipsilateral lung volume was seen with DIBH. It led to a reduction in the heart volume by 17.67%. After placement of the tangential fields, a decrease in maximum heart distance (MHD) and heart volume in treatment field (HVIF) was seen in the DIBH phase.

CONCLUSION

DIBH appears to be a useful tool for limiting cardiac and pulmonary dose in all the patients with left sided breast cancer, potentially reducing long-term complications.