Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer

Vicente Bruzzaniti, Armando Abate, Paola Pinnarò, Marco D'Andrea, Erminia Infusino, Valeria Landoni, Antonella Soriani, Carolina Giordano, Anna Maria Ferraro, Lidia Strigari

Research output: Contribution to journalArticle

Abstract

Background: To investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold (DIBH) technique during radiotherapy of breast cancer compared with Free Breathing (FB). Methods. Eight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose-volume histograms were calculated, and the volumes of heart/lung irradiated to given doses were assessed. The left anterior descending coronary artery (LAD) mean and maximum doses were calculated, together with tumour control probability (TCP) and normal tissue complication probabilities (NTCP) for lung and heart. Results: For all patients a reduction of at least 16% in lung mean dose and at least 20% in irradiated pulmonary volumes was observed when DIBH was applied. Heart and LAD maximum doses were decreased by more than 78% with DIBH. The NTCP values for pneumonitis and long term cardiac mortality were also reduced by about 11% with DIBH. The NTCP values for pericarditis were zero for both DIBH and FB. Conclusion: Delivering radiation in DIBH conditions the dose to the surrounding normal structures could be reduced, in particular heart, LAD and lung, due to increased distance between target and heart, and to reduced lung density.

Original languageEnglish
Article number88
JournalJournal of Experimental and Clinical Cancer Research
Volume32
Issue number1
DOIs
Publication statusPublished - 2013

Fingerprint

Radiotherapy
Breast Neoplasms
Lung
Respiration
Cardiac Volume
Pericarditis
Photons
Pneumonia
Coronary Vessels
Radiation
Mortality
Neoplasms
Therapeutics

Keywords

  • Breast cancer radiotherapy
  • Deep inspiration breath-hold gating radiotherapy
  • NTCP
  • TCP

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer. / Bruzzaniti, Vicente; Abate, Armando; Pinnarò, Paola; D'Andrea, Marco; Infusino, Erminia; Landoni, Valeria; Soriani, Antonella; Giordano, Carolina; Ferraro, Anna Maria; Strigari, Lidia.

In: Journal of Experimental and Clinical Cancer Research, Vol. 32, No. 1, 88, 2013.

Research output: Contribution to journalArticle

Bruzzaniti, Vicente ; Abate, Armando ; Pinnarò, Paola ; D'Andrea, Marco ; Infusino, Erminia ; Landoni, Valeria ; Soriani, Antonella ; Giordano, Carolina ; Ferraro, Anna Maria ; Strigari, Lidia. / Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer. In: Journal of Experimental and Clinical Cancer Research. 2013 ; Vol. 32, No. 1.
@article{203b63a3fcb64051beff52b1fec46b86,
title = "Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer",
abstract = "Background: To investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold (DIBH) technique during radiotherapy of breast cancer compared with Free Breathing (FB). Methods. Eight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose-volume histograms were calculated, and the volumes of heart/lung irradiated to given doses were assessed. The left anterior descending coronary artery (LAD) mean and maximum doses were calculated, together with tumour control probability (TCP) and normal tissue complication probabilities (NTCP) for lung and heart. Results: For all patients a reduction of at least 16{\%} in lung mean dose and at least 20{\%} in irradiated pulmonary volumes was observed when DIBH was applied. Heart and LAD maximum doses were decreased by more than 78{\%} with DIBH. The NTCP values for pneumonitis and long term cardiac mortality were also reduced by about 11{\%} with DIBH. The NTCP values for pericarditis were zero for both DIBH and FB. Conclusion: Delivering radiation in DIBH conditions the dose to the surrounding normal structures could be reduced, in particular heart, LAD and lung, due to increased distance between target and heart, and to reduced lung density.",
keywords = "Breast cancer radiotherapy, Deep inspiration breath-hold gating radiotherapy, NTCP, TCP",
author = "Vicente Bruzzaniti and Armando Abate and Paola Pinnar{\`o} and Marco D'Andrea and Erminia Infusino and Valeria Landoni and Antonella Soriani and Carolina Giordano and Ferraro, {Anna Maria} and Lidia Strigari",
year = "2013",
doi = "10.1186/1756-9966-32-88",
language = "English",
volume = "32",
journal = "Journal of Experimental and Clinical Cancer Research",
issn = "0392-9078",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer

AU - Bruzzaniti, Vicente

AU - Abate, Armando

AU - Pinnarò, Paola

AU - D'Andrea, Marco

AU - Infusino, Erminia

AU - Landoni, Valeria

AU - Soriani, Antonella

AU - Giordano, Carolina

AU - Ferraro, Anna Maria

AU - Strigari, Lidia

PY - 2013

Y1 - 2013

N2 - Background: To investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold (DIBH) technique during radiotherapy of breast cancer compared with Free Breathing (FB). Methods. Eight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose-volume histograms were calculated, and the volumes of heart/lung irradiated to given doses were assessed. The left anterior descending coronary artery (LAD) mean and maximum doses were calculated, together with tumour control probability (TCP) and normal tissue complication probabilities (NTCP) for lung and heart. Results: For all patients a reduction of at least 16% in lung mean dose and at least 20% in irradiated pulmonary volumes was observed when DIBH was applied. Heart and LAD maximum doses were decreased by more than 78% with DIBH. The NTCP values for pneumonitis and long term cardiac mortality were also reduced by about 11% with DIBH. The NTCP values for pericarditis were zero for both DIBH and FB. Conclusion: Delivering radiation in DIBH conditions the dose to the surrounding normal structures could be reduced, in particular heart, LAD and lung, due to increased distance between target and heart, and to reduced lung density.

AB - Background: To investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold (DIBH) technique during radiotherapy of breast cancer compared with Free Breathing (FB). Methods. Eight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose-volume histograms were calculated, and the volumes of heart/lung irradiated to given doses were assessed. The left anterior descending coronary artery (LAD) mean and maximum doses were calculated, together with tumour control probability (TCP) and normal tissue complication probabilities (NTCP) for lung and heart. Results: For all patients a reduction of at least 16% in lung mean dose and at least 20% in irradiated pulmonary volumes was observed when DIBH was applied. Heart and LAD maximum doses were decreased by more than 78% with DIBH. The NTCP values for pneumonitis and long term cardiac mortality were also reduced by about 11% with DIBH. The NTCP values for pericarditis were zero for both DIBH and FB. Conclusion: Delivering radiation in DIBH conditions the dose to the surrounding normal structures could be reduced, in particular heart, LAD and lung, due to increased distance between target and heart, and to reduced lung density.

KW - Breast cancer radiotherapy

KW - Deep inspiration breath-hold gating radiotherapy

KW - NTCP

KW - TCP

UR - http://www.scopus.com/inward/record.url?scp=84887057063&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887057063&partnerID=8YFLogxK

U2 - 10.1186/1756-9966-32-88

DO - 10.1186/1756-9966-32-88

M3 - Article

C2 - 24423396

AN - SCOPUS:84887057063

VL - 32

JO - Journal of Experimental and Clinical Cancer Research

JF - Journal of Experimental and Clinical Cancer Research

SN - 0392-9078

IS - 1

M1 - 88

ER -