Comparison of cardiac and lung doses for breast cancer patients with free breathing and deep inspiration breath hold technique in 3 dimensional conformal radiotherapy - a dosimetric study

• Autorzy: Mani K. R. , Poudel S. , Das K. J. M.

Identyfikatory

DOI

10.1515/pjmpe-2017-0018

• Języki publikacji: EN

Abstrakty

EN

Purpose: To investigate the cardio-pulmonary doses between Deep Inspiration Breath Hold (DIBH) and Free Breathing (FB) technique in left sided breast irradiation. Materials & Methods: DIBH CT and FB CT were acquired for 10 left sided breast patients who underwent whole breast irradiation with or without nodal irradiation. Three fields single isocenter technique were used for patients with node positive patients along with two tangential conformal fields whereas only two tangential fields were used in node negative patients. All the critical structures like lungs, heart, esophagus, thyroid, etc., were delineated in both DIBH and FB scan. Both DIBH and FB scans were fused with the Dicom origin as they were acquired with the same Dicom coordinates. Plans were created in the DIBH scan for a dose range between 50 Gy in 25 fractions. Critical structures doses were recorded from the Dose Volume Histogram for both the DIBH and FB data set for evaluation. Results: The average mean heart dose in DIBH vs FB was 13.18 Gy vs 6.97 Gy, (p = 0.0063) significantly with DIBH as compared to FB technique. The relative reduction in average mean heart dose was 47.12%. The relative V5 reduced by 14.70% (i.e. 34.42% vs 19.72%, p = 0.0080), V10 reduced by 13.83% (i.e. 27.79 % vs 13.96%, p = 0.0073). V20 reduced by 13.19% (i.e. 24.54 % vs 11.35%, p = 0.0069), V30 reduced by 12.38% (i.e. 22.27 % vs 9.89 %, p = 0.0073) significantly with DIBH as compared to FB. The average mean left lung dose reduced marginally by 1.43 Gy (13.73 Gy vs 12.30 Gy, p = 0.4599) but insignificantly with DIBH as compared to FB. Other left lung parameters (V5, V10, V20 and V30) shows marginal decreases in DIBH plans compare to FB plans. Conclusion: DIBH shows a substantial reduction of cardiac doses but slight and insignificant reduction of pulmonary doses as compared with FB technique. Using the simple DIBH technique, we can effectively reduce the cardiac morbidity and at the same time radiation induced lung pneumonitis is unlikely to increase.

Słowa kluczowe

EN

cardiac toxicity; lung toxicity; deep inspiration breath hold; free breathing; breast radiotherapy

• Wydawca: Polskie Towarzystwo Fizyki Medycznej ; De Gruyter
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2017
• Tom: Vol. 23, Iss. 4
• Strony: 109--114
• Opis fizyczny: Bibliogr. 9 poz., rys., tab.

Twórcy

autor

Mani K. R.

• Research & Development Centre, Bharathiar University, Coimbatore – 641 046, Tamilnadu India

autor

Poudel S.

• Department of Radiotherapy, Nepal Cancer Hospital & Research Center, Harisiddhi, Lalitpur, Nepal

autor

Das K. J. M.

• Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rai Bareily Road, Lucknow - 226014, Uttar Pradesh, India

Bibliografia

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• [8] Remouchamps VM, Letts N, Yan D, et al. Three dimensional evaluation of intra- and interfraction immobilization of lung and chest wall using active breathing control: a reproducibility study with breast cancer patients. Int J Radiat Oncol Biol Phys. 2003;57(4):968-978.
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