#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#
CS
proLékaře.cz / Journals / Perspectives in Surgery / 2021 - 4

Deep-inspiration breath hold radiotherapy in patients with left-sided breast cancer after partial mastectomy

Czech version

Authors: M. Doležel 1,2,3;  K. Odrážka 3,4,5;  J. Vaňásek 4
Authors‘ workplace: Onkologická klinika Fakultní nemocnice Olomouc 1;  Lékařská fakulta Univertity Palackého, Olomouc 2;  1. lékařská fakulta Univerzity Karlovy, Praha 3;  KOC Pardubická krajská nemocnice, a. s., a Multiscan, s. r. o., Pardubice 4;  3. lékařská fakulta Univerzity Karlovy, Praha 5
Published in: Rozhl. Chir., 2021, roč. 100, č. 4, s. 180-185.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2021.100.4.

Overview

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.

Keywords:

deep−inspiration breath hold radiotherapy−breast cancer−cardiovascular toxicity−adjuvant radiotherapy

Sources
  1. Early Breast Cancer Trialists’ Collaborative Group. Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Lancet 2000;355:1757–1770.
  2. Gasparini G, Panizzoni GA, Dal Fior S, et al. Conservative surgery and irradiation (QUART) in the treatment of 243 stage I–II breast cancer patients. Anticancer Res. 1991;11:1635–1640. PMID: 1746920.
  3. Rose MA, Olivotto I, Cady B, et al. Conservative surgery and radiation therapy for early breast cancer long term cosmetic results. Arch Surg. 1989;124:153–157. doi:10.1001/archsurg.1989.01410020023002. 
  4. Melichar B, Doležal J, Srámek V, et al. Pre­valence of perfusion defects detected by stress 99mtechnetium sestamibi myocardial perfusion single-photon emission computed tomography in asymptomatic patients with breast cancer. Anticancer Res. 2014;34(7):3689−3694.
  5. Rutqvist LE, Johansson H. Mortality by laterality of the primary tumour among 55,000 breast cancer patients from the Swedish Cancer Registry. Br J Cancer 1990;61:866−868. doi:10.1038/bjc.1990.193. 
  6. Paszat LF, Mackillop WJ, Groome PA, et al. Mortality from myocardial infarction after adjuvant radiotherapy for breast cancer in the Surveillance, Epidemiology, and End-Results cancer registries. J Clin Oncol. 1998;16:2625−2631. doi:10.1200/JCO.1998.16.8.2625.
  7. McGale P, Darby SC, Hall P, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiother Oncol. 2011;100:167−175. doi:10.1016/j.radonc.2011.06.016. 
  8. Darby SC, McGale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. Lancet Oncol. 2005;6:557–65. doi:10.1016/S1470-2045(05)70251-5.
  9. Darby SC, Ewertz M, McGale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368:987−998. doi:10.1056/NEJMoa1209825.
  10. van den Bogaard VA, Ta BD, van der Schaaf A, et al. Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures. J Clin Oncol. 2017;35(11):1171−1178. doi:10.1200/JCO.2016.69.8480.
  11. Dolezel M, Odrazka K, Vanasek J, et al. Audio-visual navigation reduces treatment time in deep-inspiration breath hold radiotherapy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020;164(4):461−466. doi:10.5507/bp.2019.051.
  12. Hlavka A, Vanasek J, Odrazka K, et al. Tumor bed radiotherapy in women following breast conserving surgery for breast cancer-safety margin with/without image guidance. Oncol Lett. 2018;15(4):6009−6014. doi:10.3892/ol.2018.8083.
  13. Mehta LS, Watson KE, Barac A, et al. Cardiovascular disease and breast cancer: Where these entities intersect: A scientific statement from the American Heart Association. Circulation. Circulation. 2018;137(8):e30−e66. doi:10.1161/CIR.0000000000000556.
  14. Lorenzen LL, Rehammar CHJ, Jensen MB, et al. Radiation-induced risk of ischemic heart disease following breast cancer radiotherapy in Denmark, 1977−2005. Radiother Oncol. 2020;152:103−110. doi: 10.1016/j.radonc.2020.08.007.
  15. Lai J, Hu S, Luo Y, et al. Meta-analysis of deep inspiration breath hold (DIBH) versus free breathing (FB) in postoperative radiotherapy for left-side breast cancer. Breast Cancer 2020;27(2):299−307. doi:10.1007/s12282-019-01023-9.
  16. Simonetto C, Eidemüller M, Gaasch A, et al. Does deep inspiration breath-hold prolong life? Individual risk estimates of ischaemic heart disease after breast cancer radiotherapy. Radiother Oncol. 2019;131:202−207. doi:10.1016/j.radonc. 2018.07.024.
  17. Sakka M, Kunzelmann L, Metzger M, et al. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradia­tion: Is IMRT more beneficial than VMAT? Strahlenther Onkol. 2017;193(10):800−811. doi:10.1007/s00066-017-1167-0.
  18. Corradini S, Ballhausen H, Weingandt H, et al. Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease : Effects of modern radiotherapy techniques. Strahlenther Onkol. 2018;194(3):196−205. doi:10.1007/s00066-017-1213-y.
  19. Duma MN, Herr AC, Borm KJ, et al. Tangential field radiotherapy for breast cancer-the dose to the heart and heart subvolumes: What structures must be contoured in future clinical trials? Front Oncol. 2017;19;7:130. doi:10.3389/fonc.2017.00130.
  20. Munshi A, Khataniar N, Sarkar B, et al. Spatial orientation of coronary arteries and its implication for breast and thoracic radiotherapy-proposing „coronary strip“ as a new organ at risk. Strahlenther Onkol. 2018;194(8):711−718. doi:10.1007/s00066-018-1299-x.
  21. Song J, Tang T, Caudrelier JM, et al. Dose-sparing effect of deep inspiration breath hold technique on coronary artery and left ventricle segments in treatment of breast cancer. Radiother Oncol. 2020;154:101−109. doi:10.1016/j.radonc.2020.09.019.
  22. Bartlett FR, Donovan EM, McNair HA, et al. The UK HeartSpare Study (Stage II): Multicentre evaluation of a voluntary breath-hold technique in patients receiving breast radiotherapy. Clin Oncol. (R Coll Radiol.) 2017;29(3):e51−e56. doi:10.1016/j.clon.2016.11.005.
  23. Smith BD, Bellon JR, Blitzblau R, et al. Radiation therapy for the whole breast: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline. Pract Radiat Oncol. 2018;(3):145−152. doi:10.1016/j.prro.2018.01.012.
  24. Duma MN, Baumann R, Budach W, et al. Heart-sparing radiotherapy techniques in breast cancer patients: a recommendation of the breast cancer expert panel of the German society of radiation oncology (DEGRO). Strahlenther Onkol. 2019 Oct;195(10):861−871. doi:10.1007/s00066-019-01495-w.
Labels
Surgery Orthopaedics Trauma surgery
Breast cancer − medical oncology summary 2021
Ductal carcinoma in situ and the extent of surgery
Paget’s disease of the breast – observational retrospective study of the past 20 years
100 let časopisu České chirurgické společnosti ČLS JEP
Ke zrodu časopisu Rozhledy v chirurgii
Kam směřuje péče o karcinom prsu
Surgical solution of the extensive post-radiation defect developped 33 years after radiotherapy for breast carcinoma − case report
Granulomatous mastitis − treatment options and our experience
Sebaceous carcinoma of the breast area − a case report
Article was published in

Perspectives in Surgery

Issue 4
2021 Issue 4
Most read in this issue
Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#