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Deep inspiration breath hold reduces the mean heart dose in left breast cancer radiotherapy

Michał Falco
Michał Falco
, 
Bartłomiej Masojć
Bartłomiej Masojć
, 
Agnieszka Macała
Agnieszka Macała
, 
Magdalena Łukowiak
Magdalena Łukowiak
, 
Piotr Woźniak
Piotr Woźniak
 oraz 
Julian Malicki
Julian Malicki
   | 29 sty 2021
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Article Category: Research Article
Data publikacji: 29 sty 2021
Zakres stron: 212 - 220
Otrzymano: 07 paź 2020
Przyjęty: 18 lis 2020
DOI: https://doi.org/10.2478/raon-2021-0008
© 2021 Michał Falco, Bartłomiej Masojć, Agnieszka Macała, Magdalena Łukowiak, Piotr Woźniak, Julian Malicki, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Mean heart dose (MHD) values by year 2014–2017.
Mean heart dose (MHD) values by year 2014–2017.

Figure 2

Fractionation-corrected mean heart dose (MHDfx) values by year 2014– 2017.
Fractionation-corrected mean heart dose (MHDfx) values by year 2014– 2017.

Mean heart dose (MHD) and fractionation corrected MHD (MHDfx) according to radiation technique

FBFB-GRTDIBHp
Patients, n540183252
MHD< 4 Gy350142240< 0.0001
≥ 4 Gy1904112
MHDfx< 4 Gy ≥ 4 Gy340 200137 46237 15< 0.0001

Comparison of mean V40%, V60%, V80%, V100% values obtained from 2014 to 2017 and between radiation techniques

YearV100 cm3V80 cm3V60 cm3V40 cm3
20140.75 (0.46–1.03)7.21 (5.6–8.82)16.75 (13.98–19.51)33.02 (28.22–37.82)
20150.54 (0.22–0.87)4.31 (3.3–5.32)9.56 (7.9–11.21)40.68 (3.03–78.33)
20160.20 (0.02–0.38)2.73 (2.04–3.42)7.91 (6.56–9.26)16.9 (14.49–19.30)
20170.08 (-0.0096–0.16)1.13 (0.32–1.94)3.13 (1.93–4.32)9.1 (4.44–13.76)
2014 vs. 2015: NS2014 vs. 2015: p = 0.00182014 vs. 2015: p < 0.0012014 vs. 2015: NS
2015 vs. 2016: NS2015 vs. 2016: p = 0.00962015 vs. 2016: NS2015 vs. 2016: NS
2016 vs. 2017: NS2016 vs. 2017: p = 0.00292016 vs. 2017: p < 0.00012016–2017: p = 0.0027
FB0.37 (0.22–0.52)4.46 (3.67–5.25)11.2 (9.9–12.5)33.13 (16.22–50.03)
FB-GRT0.76 (0.36–1.17)4.7 (3.61–5.79)9.87 (7.83–11.9)17.75 (13.95–21.56)
DIBH0.06 (-0.02–0.14)0.71 (0.37–1.05)2.3 (1.48–3.13)7.47 (2.71–12.23)
FB vs. FB-GRT: p = 0.0274FB vs. FB-GRT: NSFB vs. FB-GRT: NSFB vs. FB-GRT: NS
FB vs. DIBH: p = 0.0107FB vs. DIBH: p < 0.0001FB vs. DIBH: p < 0.0001FB vs. DIBH: p = 0.0529
FB-GRT vs. DIBH: p < 0.0001FB-GRT vs. DIBH: p < 0.0001FB-GRT vs. DIBH: p < 0.0001FB-GRT vs. DIBH: p = 0.0019

Mean heart dose (MHD) and fractionation-corrected MHD (MHDfx) by year of treatment and side, regional nodal irradiation and body mass index

MHD2014201520162017
SideLeft3.93 (3.53–4.33)3.44 (3.19–3.68)3.27 (3.07–3.49)2.23 (2.1–2.37)
Right1.55 (1.27–1.83)1.54 (1.4–1.67)1.37 (1.28–1.46)1.47 (1.38–1.56)
p< 0.0001< 0.0001< 0.0001< 0.0001
RNINo3.86 (3.34–4.37)3.2 (2.87–3.54)2.98 (2.71–3.25)1.91 (1.77–2.07)
Yes4.03 (3.39–4.67)3.68 (3.32–4.03)3.56 (3.27–3.91)2.64 (2.41–2.86)
pNSNS0.0038< 0.0001
BMI< 303.23 (2.8–3.65)2.53 (2.32–2.82)2.66 (2.38–2.94)1.92 (1.71–2.14)
≥ 304.38 (3.8–4.97)4.05 (3.73–4.38)3.63 (3.35–3.91)2.38 (2.21–2.55)
p0.0053< 0.0001< 0.00010.002
MHDfx2014201520162017
SideLeft4.03 (3.63–4.43)3.6 (3.35–3.84)3.41 (3.2–3.61)2.42 (2.28–2.56)
Right1.64 (1.36–1.93)1.65 (1.51–1.8)1.45 (1.36–1.54)1.62 (1.52–1.72)
p0.00010.00010.00010.0001
RNINo3.98 (3.46–4.5)3.47 (3.12–3.82)3.18 (2.91–3.45)2.16 (2–2.32)
Yes4.1 (3.44–4.75)3.72 (3.36–4.08)3.65 (3.33–3.96)2.76 (2.53–2.98)
pNSNS0.02720.0001
BMI< 303.29 (2.87–3.71)2.7 (2.39–3.01)2.79 (2.51–3.07)2.12 (1.9–2.34)
≥ 304.5 (3.91–5.09)4.2 (3.87–4.53)3.76 (3.49–4.04)2.56 (2.39–2.74)
p0.0036< 0.0001< 0.00010.0029

Mean heart dose (MHD) and fractionation-corrected MHD (MHDfx) by year of treatment

2014201520162017p
Patients, n160255294266
MHD (Gy)< 498175211248< 0.0001
≥ 462808318
Mean (95% CI)3.93 (3.53–4.33)3.44 (3.19–3.68)3.27 (3.07–3.49)2.23 (2.1–2.37)
2014 vs. 2015: p = 0.027, 2015 vs. 2016: NS, 2016–2017: p < 0.0001
MHDfx (Gy)< 496168205245< 0.0001
≥ 464878921
Mean (95% CI)4.03 (3.63–4.43)3.6 (3.35–3.84)3.41 (3.2–3.61)2.42 (2.28–2.56)
2014 vs. 2015: p = 0.0551, 2015–2016: NS, 2016–2017: p< 0.0001

Mean heart dose (MHD) and fractionation-corrected MHD (MHDfx) according to radiation technique and regional nodal irradiation, body mass index

MHDFBFB-GRTDIBH
RNINo3.5 (3.23–3.77)3.07 (2.75–3.39)1.89 (1.75–2.04)
Yes3.62 (3.42–3.83)4.59 (3–6.19)2.45 (2.21–2.69)
pNS0.003< 0.0001
BMI< 302.72 (2.52–2.93)2.78 (2.4–3.15)1.92 (1.69–2.16)
≥ 304.04 (2.83–4.25)3.7 (3.14–4.27)2.19 (2.03–2.34)
p< 0.00010.0103NS
MHDfxFBFB-GRTDIBH
RNINo3.71 (3.44–3.99)3.25 (2.94–3.57)2.15 (1.99–2.3)
Yes3.69 (3.48–3.88)4.66 (3.05–6.27)2.58 (2.33–2.82)
pNS0.00610.0026
BMI< 302.83 (2.62–3.03)2.96 (2.57–3.35)2.12 (1.89–2.36)
≥ 304.16 (3.95–4.37)3.86 (3.3–4.42)2.4 (2.23–2.57)
p< 0.00010.0125NS

Patient clinical characteristics by year of treatment

Variable
2014201520162017p-value
Right155277278263
SideNS
Left201284298266
< 25712148
25–30671019777
BMINS
30–3565102101117
> 3562698563
BCS137188201182
Operation typeNS
Mastectomy64929582
N(-)129159180174
Nodal statusNS
N(+)7212111690
No127146156149
RNINS
Yes74138142117
No16519216780
HFX< 0.0001
Yes3692131186
FB12219720038
GatedFB-GRT4276700
radiotherapy< 0.0001
DIBH0024228
IMRT371140
eISSN:
1581-3207
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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