aDIBH Reduces Heart and Lung Dose in Left Breast RT

Junming Lai and the team aimed to evaluate the dosimetric efficacy of abdominal deep inspiration breath hold (aDIBH) with audio guidance in patients with left breast cancer receiving postoperative adjuvant radiotherapy (RT), comparing it to free breathing (FB).

About 35 patients with early-stage left breast cancer underwent 2 CT simulation scans—1 with aDIBH and 1 with FB—after breast-conserving surgery. Treatment planning was optimized using the Pinnacle3 9.10 system. The heart, left anterior descending coronary artery (LADCA), and left lung were designated as organs at risk. Dosimetric differences in the planning target volume (PTV) and organs at risk were compared between aDIBH and FB.

Results showed that, compared to FB, the heart moved farther caudally and away from the chest wall, and the heart volume decreased under aDIBH due to lung expansion. The D mean of the heart, LADCA, and left lung with aDIBH was reduced by 332.79 ± 264.61 cGy (P< 0.001), 1290.37 ± 612.09 cGy (P< 0.047), and 69.94 ± 117.73 cGy (P< 0.001), respectively.

The V20 and V30 of the organs at risk were also significantly reduced with statistical differences (P< 0.05). Additionally, no significant differences were found in the dosimetric parameters of the PTV between the groups (P> 0.05).

The study concluded that implementing the aDIBH technique for postoperative radiotherapy after breast-conserving surgery for left breast cancer can reduce heart, LADCA, and left lung irradiation without compromising target coverage.

No funding was provided.

Source: https://pubmed.ncbi.nlm.nih.gov/39307905/

Lai J, Luo H, Hu S, et al. (2024). “Dose advantage of abdominal deep inspiratory breath-hold (aDIBH) in postoperative adjuvant radiotherapy for left breast cancer.” J Egypt Natl Canc Inst. 2024;36(1):29. Published 2024 Sep 23. doi:10.1186/s43046-024-00234-2