Keywords
Breast-conserving surgery
Deep inspiration breath hold
Free breathing
Cardiac dose
Submitted : 2023-08-26
Accepted : 2023-09-10
Published : 2023-09-25
Abstract
Objective: To analyze the application of deep inspiration breath hold technique in radiotherapy after breast-conserving surgery for left breast cancer and the improvement of cardiac dose. Methods: A total of 45 patients with left breast cancer treated in our hospital after breast-conserving surgery were selected, and the selection time was set from January 2020 to August 2022. All patients received radiotherapy. The right breast, heart, and lung volumes, and dose parameters of the heart, lungs, right breast, and left anterior descending coronary artery were compared under free breathing (FB) and deep inspiration breath hold (DIBH) technical modes. Results: The heart volume of the DIBH group was smaller than that of the FB group, and the left and right lung volumes were significantly larger than those of the FB group. In the DIBH group, the heart dose parameters V5, proper lung dose parameters, and left anterior descending coronary artery dose parameters were found lower than that of the FB group, and the differences were statistically significant (P < 0.05). Conclusion: Compared with FB, the DIBH technique can reduce the heart’s size and increase the lung volume when used for radiotherapy after breast-conserving surgery for left breast cancer. It also reduces the dose to the heart, right lung, and left anterior descending coronary artery, thus protecting the heart and lungs.
References
Liang G, Du W, Jiang S, et al., 2023, Research Progress on Image-Guided Technology for Intensity-Modulated Radiotherapy after Breast-Conserving Surgery for Breast Cancer. International Journal of Medical Radiology, 46(4): 462–467.
Chen Y, Yang X, Wang H, et al., 2022, Analysis of the Influence of Dual-Dimensional Four-in-One Nursing on Patients’ Compliance and Disease Coping Style with Breast Cancer Radiotherapy. Journal of Chengdu Medical College, 17(2): 201–203 + 207.
Chai L, Zhou C, Meng D, et al., 2021, Dosimetric Analysis of Deep Inhalation Breath-Holding Technique in Dynamic Volume Rotation Intensity-Modulated Radiotherapy After Breast-Conserving Surgery for Left Breast Cancer. Journal of Modern Oncology, 29(21): 3830–3833.
Shao Y, Wang Y, Wang S, et al., 2020, Dosimetric Study of Different Optimization Methods in Hypofractionated Radiotherapy for Breast Cancer. Chinese Journal of Medical Physics, 37(7): 843–849.
Hu H, Li M, Xiao G, 2020, Application of Deep Inhalation and Breath-Holding Technique in Postoperative Radiotherapy for Left Breast Cancer (with 41 Cases). Journal of Modern Oncology, 28(13): 2318–2322.
Breast Cancer Professional Committee of Chinese Anti-Cancer Association. Chinese Anti-Cancer Association Guidelines and Norms for Diagnosis and Treatment of Breast Cancer (2019 Edition). Chinese Journal of Cancer, 29(8): 609–679.
Zhang Q, Fang X, Liu J, et al., 2022, Study on the Safety of Hypofractionated Radiotherapy Concurrent with Tumor Bed Boost and the Importance of Cardiac Substructure Dose Assessment for Early Left Breast Cancer After Breast- Conserving Surgery. Chinese Journal of Cancer, 32 (5): 427–435.
Shi Y, Huang R, Gao Y, et al., 2022, Comparison of Dosimetry between Hybrid-IMRT and Hybrid-VMAT Under Deep Inhalation and Breath-Holding Mode After Breast-Conserving Surgery for Left Breast Cancer. Chinese Journal of Medical Physics, 39(8): 936–940.
Li L, Wang X, Wang Y, et al., 2022, Research Progress on Deep Inhalation and Breath-Holding Techniques in Breast Cancer Radiotherapy. Journal of Oncology, 28(1): 63–66.
Wu Q, Chen Q, Yang Y, 2022, Research Progress on Applying Deep Inhalation and Breath-Hold Technique in Radiotherapy for Left Breast Cancer. Journal of Modern Oncology, 30(12): 2290–2295.
Wu H, Zhong H, Zhang G, et al., 2023, Study on the Influence of CT End Optical Positioning Equipment on the Positioning Accuracy of DIBH Radiotherapy for Left Breast Cancer Guided by Optical Surface. China Medical Equipment, 38(1): 48–52.
Li T, Zhang J, Wang S, et al., 2021, Application of Breathing Training Module Based on Visual Feedback in Deep Inspiration Breath-Hold Radiotherapy for Left Breast Cancer. Chinese Journal of Radiation Oncology, 30(3): 258–261.
Duo G, Feng J, Wang L, et al., 2021, Meta-Analysis of Lung Dose Using Deep Inhalation and Breath-Holding Technique for Radiotherapy After Breast-Conserving Surgery for Left Breast Cancer. Modern Oncology, 29(23): 4196–4200.
Zhang G, Zhong H, Wu H, et al., 2021, Clinical Application and Evaluation of Deep Inhalation and Breath-Hold Therapy for Left Breast Cancer Guided by Optical Surface Monitoring System. Chinese Journal of Medical Physics, 38(7): 793–797.
Yu S, Chen S, Wang S, et al., 2020, Study on the Setup Error of Deep-Breathing and Breath-Holding and Free-Breathing in Whole-Breast Intensity-Modulated Radiotherapy Under Breast Bracket Fixation. Chinese Journal of Radiation Oncology, 29(10): 877–881.