J Breast Cancer.  2012 Mar;15(1):105-110. 10.4048/jbc.2012.15.1.105.

Dose-Volume Analysis of Lung and Heart according to Respiration in Breast Cancer Patients Treated with Breast Conserving Surgery

• Shim JG
• Kim JK
• Park W
• Seo JM
• Hong CS
• Song KW
• Lim CH
• Jung HR
• Kim CH

• KMID: 2286481
• DOI: http://doi.org/10.4048/jbc.2012.15.1.105

Abstract

PURPOSE
Adjuvant radiotherapy of breast cancer using a photon tangential field incurs a risk of late heart and lung toxicity. The use of free breathing (FB), expiration breath hold (EBH), and deep inspiration breath hold (DIBH) during tangential breast radiotherapy as a means of reducing irradiated lung and heart volume was evaluated.
METHODS
In 10 women with left-sided breast cancer (mean age, 44 years) post-operative computed tomography (CT) scanning was done under different respiratory conditions using FB, EBH, and DIBH in 3 CT scans. For each scan, an optimized radiotherapy plan was designed with 6 MV photon tangential fields encompassing the clinical target volume after breast-conserving surgery.
RESULTS
The results of dose-volume histograms were compared using three breathing pattern techniques for the irradiated volume and dose to the heart. A significant reduction dose to the irradiated heart volume for the DIBH breathing technique was compared to FB and EBH breathing techniques (p<0.05).
CONCLUSION
This study demonstrated that the irradiated heart volume can be significantly reduced in patients with left-sided breast cancer using the DIBH breathing technique for tangential radiotherapy.

Keyword

Breast neoplasms; Heart; Lung; Radiotherapy

MeSH Terms

Breast
Breast Neoplasms
Cardiac Volume
Female
Heart
Humans
Lung
Mastectomy, Segmental
Radiotherapy, Adjuvant
Respiration

Figure

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  Figure 1 Axial images of computed tomography. (A) Free breathing. (B) Expiration breath hold. (C) Deep inspiration breath hold.

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  Figure 2 Digitally reconstructed radiograph images in chest. (A) Lung volume. (B) Heart volume. (C) Maximum heart distance. (D) Central lung distance. ILV=irradiated lung volume; IHV=irradiated heart volume; CLD=central lung distance; MHD=maximum heart distance.

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