Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer

Journal of Experimental & Clinical Cancer Research

Lidia Strigari²  Anna Maria Ferraro⁴  Carolina Giordano⁴  Antonella Soriani²  Valeria Landoni²  Erminia Infusino³  Marco D’Andrea²  Paola Pinnarò⁴  Armando Abate¹  Vicente Bruzzaniti² 

[1] Radiotherapy Department, Istituto Neurotraumatologico Italiano, Grottaferrata, Italy;Laboratory of Medical Physics and Expert System, Regina Elena Cancer Institute, Via E. Chianesi 53, 00144 Rome, Italy;Radiotherapy Department, Campus Bio-Medico University, Rome, Italy;Radiotherapy Department, Regina Elena Cancer Institute, Rome, Italy

关键词: TCP;    NTCP;    Breast cancer radiotherapy;    Deep inspiration breath-hold gating radiotherapy;   

Others  :  814274
DOI  :  10.1186/1756-9966-32-88

 received in 2013-08-05, accepted in 2013-10-29,  发布年份 2013

【 摘 要 】

Background

To investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold (DIBH) technique during radiotherapy of breast cancer compared with Free Breathing (FB).

Methods

Eight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose–volume histograms were calculated, and the volumes of heart/lung irradiated to given doses were assessed. The left anterior descending coronary artery (LAD) mean and maximum doses were calculated, together with tumour control probability (TCP) and normal tissue complication probabilities (NTCP) for lung and heart.

Results

For all patients a reduction of at least 16% in lung mean dose and at least 20% in irradiated pulmonary volumes was observed when DIBH was applied. Heart and LAD maximum doses were decreased by more than 78% with DIBH. The NTCP values for pneumonitis and long term cardiac mortality were also reduced by about 11% with DIBH. The NTCP values for pericarditis were zero for both DIBH and FB.

Conclusion

Delivering radiation in DIBH conditions the dose to the surrounding normal structures could be reduced, in particular heart, LAD and lung, due to increased distance between target and heart, and to reduced lung density.

【 授权许可】

   
2013 Bruzzaniti et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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