Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes.

Speleers, Bruno; Schoepen, Max; Belosi, Francesca; Vakaet, Vincent; De Neve, Wilfried; Deseyne, Pieter; Paelinck, Leen; Vercauteren, Tom; Parkes, Michael J; Lomax, Tony; Van Greveling, Annick; Bolsi, Alessandra; Weber, Damien C; Veldeman, Liv; De Gersem, Werner (2021). Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes. Scientific reports, 11(1), p. 6085. Springer Nature 10.1038/s41598-021-85401-4

Preview

Text s41598-021-85401-4.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview

We report on a comparative dosimetrical study between deep inspiration breath hold (DIBH) and shallow breathing (SB) in prone crawl position for photon and proton radiotherapy of whole breast (WB) and locoregional lymph node regions, including the internal mammary chain (LN_MI). We investigate the dosimetrical effects of DIBH in prone crawl position on organs-at-risk for both photon and proton plans. For each modality, we further estimate the effects of lung and heart doses on the mortality risks of different risk profiles of patients. Thirty-one patients with invasive carcinoma of the left breast and pathologically confirmed positive lymph node status were included in this study. DIBH significantly decreased dose to heart for photon and proton radiotherapy. DIBH also decreased lung doses for photons, while increased lung doses were observed using protons because the retracting heart is displaced by low-density lung tissue. For other organs-at-risk, DIBH resulted in significant dose reductions using photons while minor differences in dose deposition between DIBH and SB were observed using protons. In patients with high risks for cardiac and lung cancer mortality, average thirty-year mortality rates from radiotherapy-related cardiac injury and lung cancer were estimated at 3.12% (photon DIBH), 4.03% (photon SB), 1.80% (proton DIBH) and 1.66% (proton SB). The radiation-related mortality risk could not outweigh the ~ 8% disease-specific survival benefit of WB + LN_MI radiotherapy in any of the assessed treatments.

Interest & Impact

Downloads

67 since deposited on 19 Apr 2021
16 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item