The cardiac dose‐sparing benefits of deep inspiration breath‐hold in left breast irradiation: a systematic review

Journal of Medical Radiation Sciences

Lloyd M. Smyth MMedRad (RT), BBiomed¹  Kellie A. Knight HScD, MHlthSc (RT), BAppSc (RT)²  Yolanda K. Aarons BAppSc (MedRad)¹ 

[1] Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria;Department of Medical Imaging & Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing & Health Sciences, Monash University, Clayton, Victoria

关键词: Adverse effects;    breast neoplasms;    heart;    radiotherapy;    review;   

DOI  :  10.1002/jmrs.89

来源: Wiley

【 摘 要 】

Abstract

Introduction

Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique.

Methods

An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed.

Results

Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease.

Conclusion

DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

【 授权许可】

CC BY-NC-ND   
© 2015 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology.

Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.