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Cancers 2019, 11(2), 259; https://doi.org/10.3390/cancers11020259

A Retrospective Dosimetric Study of Radiotherapy Patients with Left-Sided Breast Cancer; Patient Selection Criteria for Deep Inspiration Breath Hold Technique

1
Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
2
GenesisCare, Adelaide, SA 5000, Australia
3
Department of Physics, University of Adelaide, Adelaide, SA 5005, Australia
*
Author to whom correspondence should be addressed.
Received: 10 January 2019 / Revised: 14 February 2019 / Accepted: 19 February 2019 / Published: 22 February 2019
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Abstract

Background: Several studies have investigated cardiac dose reduction when utilizing the deep inspiration breath hold (DIBH) technique in patients undergoing radiotherapy for left-sided breast cancer. This paper aims to recommend potential selection criteria based on a retrospective single institute study of free breathing (FB) and DIBH computed tomography (CT) simulation planning scans. Methods: Dosimetric comparisons were performed retrospectively for 20 patients correlating the dose reduction and patient anatomical factors (anatomical variation of chest shape, chest wall separation, total lung volume (TLV) and others). Results: Paired t-tests demonstrated significant cardiac dose reduction for most patients but not all. Minimal cardiac dose reduction was observed for three patients using their DIBH plan, with one patient receiving a higher dose. Linear regression analysis identified a positive correlation between the patient’s TLV (on the FB CT simulation scan) and the magnitude of dosimetric benefit received (0.4045 R2). Conclusion: The TLV measured on a FB plan could potentially be utilised to predict cardiac exposure and assist with patient selection for DIBH. This is important in resource allocation, as DIBH may be unnecessarily recommended for some patients with little dosimetric benefit. View Full-Text
Keywords: Deep inspiration breath hold; DIBH; left-sided breast cancer; total lung volume; TLV; chest wall separation; CWS; selection criteria Deep inspiration breath hold; DIBH; left-sided breast cancer; total lung volume; TLV; chest wall separation; CWS; selection criteria
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Dell’Oro, M.; Giles, E.; Sharkey, A.; Borg, M.; Connell, C.; Bezak, E. A Retrospective Dosimetric Study of Radiotherapy Patients with Left-Sided Breast Cancer; Patient Selection Criteria for Deep Inspiration Breath Hold Technique. Cancers 2019, 11, 259.

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