Voluntary deep inspiration breath-hold reduces the heart dose without compromising the target volume coverage during radiotherapy for left-sided breast cancer
, , , , , , , , and | Feb 23, 2018
About this article
Article Category: Research Article
Published Online: Feb 23, 2018
Page range: 112 - 120
Received: Oct 26, 2017
Accepted: Jan 15, 2018
DOI: https://doi.org/10.1515/raon-2018-0008
© 2018 Noora Al-Hammadi, Palmira Caparrotti, Carole Naim, Jillian Hayes, Katherine Rebecca Benson, Ana Vasic, Hissa Al-Abdulla, Rabih Hammoud, Saju Divakar, Primoz Petric
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Figure 1
Mean values +/– standard deviations of dose volume histogram (DVH) parameters for heart, left anterior descending coronary artery (LAD), lung and optimized planning target volume (OPTV) achieved by the free breathing and breath-hold technique.
| DVH parameter | Free breathing | Breath-hold | P-value |
|---|---|---|---|
| Dmean [Gy] | 6.1 +/– 2.5 | 3.2 +/– 1.4 | |
| Dmax [Gy] | 51.1 +/– 1.4 | 48.5 +/– 6.8 | |
| V50Gy [%] | 0.7 +/– 1.1 | 0.2 +/– 0.6 | |
| V40Gy [%] | 6.2 +/– 3.5 | 2.1 +/– 1.9 | |
| V30Gy [%] | 7.8 +/– 4 | 2.8 +/– 2.3 | < 0.05 |
| V25Gy [%] | 8.5 +/– 4.2 | 3.2 +/– 2.5 | |
| V20Gy [%] | 9.2 +/– 4.4 | 3.6 +/– 2.7 | |
| V15Gy [%] | 10 +/– 4.6 | 4.1 +/– 2.9 | |
| V10Gy [%] | 11.2 +/– 5 | 4.9 +/– 3.2 | |
| Dmean [Gy] | 11.3 +/– 3.2 | 10.6 +/– 2.6 | |
| Dmax [Gy] | 51.6 +/– 1.8 | 50.6 +/– 1.1 | |
| V30Gy [%] | 17.9 +/– 6.3 | 17 +/– 4.6 | NS |
| V20Gy [%] | 20.5 +/– 7 | 19.5 +/– 5.1 | |
| V10Gy [%] | 25.9 +/– 8.1 | 25.4 +/– 5.8 | |
| Dmean [Gy] | 23.0 +/– 6.7 | 14.8 +/– 7.6 | |
| Dmax [Gy] | 49.7 +/– 3.4 | 44.3 +/– 12.2 | < 0.05 |
| D50% [Gy] | 20.4 +/– 17.6 | 8.4 +/– 11.1 | |
| V95% [%] | 95.6 +/– 4.1 | 95.2 +/– 6.3 | NS |
Vertical, longitudinal and lateral couch shifts and corresponding systematic and random errors for the initial 18 patients treated with voluntary deep inspiration breath-hold (V-DIBH) and a historic control treated with free-breathing (FB) technique. Differences between the two approaches were non-significant.
| Vertical [mm] | Longitudinal [mm] | Lateral [mm] | ||||
|---|---|---|---|---|---|---|
| Mean shift | 1 | 1.2 | 2.8 | 2.7 | 1.9 | 2.1 |
| Systematic error | 0.7 | 1.5 | 1.6 | 2.1 | 0.8 | 1.3 |
| Random error | 0.6 | 0.6 | 2.1 | 0.7 | 1.1 | 0.4 |
Impact of supraclavicular fossa (SCF) radiotherapy on heart and lung dose volume histogram (DVH) parameters
| DVH parameter | Free breathing | p-value | Breath hold | p-value | ||
|---|---|---|---|---|---|---|
| Dmean [Gy] | 5.5 +/– 2.2 | 6.6 +/– 2.7 | 2.9 +/– 1.1 | 3.5 +/– 1.6 | ||
| Dmax [Gy] | 51.1 +/– 1.5 | 51.1 +/– 1.3 | 48.2 +/– 7.8 | 48.8 +/– 5.9 | ||
| V50Gy [%] | 1 +/– 1.3 | 0.5 +/– 0.9 | 0.3 +/– 0.7 | 0.2 +/– 0.3 | ||
| V40Gy [%] | 5.9 +/– 3.6 | 6.5 +/– 3.4 | NS | 1.6 +/– 1.4 | 2.4 +/– 2.2 | NS |
| V30Gy [%] | 7.2 +/– 4.1 | 8.3 +/– 3.9 | 2.3 +/– 1.8 | 3.3 +/– 2.6 | ||
| V25Gy [%] | 7.8 +/– 4.2 | 9.1 +/– 4.1 | 2.6 +/– 1.9 | 3.7 +/– 2.8 | ||
| V20Gy [%] | 8.4 +/– 4.4 | 9.8 +/– 4.4 | 2.9 +/– 2.1 | 4.2 +/– 3 | ||
| V15Gy [%] | 9.2 +/– 4.7 | 10.6 +/– 4.5 | 3.4 +/– 2.3 | 4.7 +/– 3.2 | ||
| V10Gy [%] | 10.4 +/– 5.1 | 12 +/– 4.8 | 4.2 +/– 2.6 | 5.6 +/– 3.5 | ||
| Dmean [Gy] | 9 +/– 2.6 | 13.2 +/– 2.2 | < 0.05 | 9.3 +/– 3.2 | 11.8 +/– 2.4 | < 0.05 |
| Dmax [Gy] | 51.1 +/– 1.4 | 52 +/– 2.1 | NS | 50.4 +/– 1.1 | 50.8 +/– 1.1 | NS |
| V30Gy [%] | 13.4 +/– 4.9 | 21.7 +/– 4.7 | 14 +/– 4 | 19.6 +/– 3.3 | ||
| V20Gy [%] | 15.5 +/– 5.3 | 24.9 +/– 5.1 | < 0.05 | 16.3 +/– 4.4 | 22.3 +/– 3.8 | < 0.05 |
| V10Gy [%] | 19.8 +/– 6.1 | 31.2 +/– 5.5 | 21.5 +/– 5.5 | 28.8 +/– 3.6 | ||