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Updated: Jul 23, 2025
11:38
Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
Published on: July 3, 2014
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Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for
Fabiana Accioli Miranda Degrande1, Gustavo Nader Marta2, Tatiana Midori Martins Teles Alves2
1Department of Radiation Oncology, Santa Paula Hospital, Santo Amaro, Sao Paulo, Brazil.
Summary
Deep inspiration breath hold (DIBH) significantly reduces heart and LAD radiation dose in left breast cancer patients compared to free breathing (FB) RT. This technique maintains target coverage while improving cardiac and coronary artery safety.
Area of Science:
- Radiation Oncology
- Medical Physics
- Cardiovascular Imaging
Background:
- Postoperative radiation therapy (RT) is standard for breast cancer.
- Cardiac dose is a concern, especially for left-sided treatment.
- Deep inspiration breath hold (DIBH) may reduce heart exposure during RT.
Purpose of the Study:
- To compare the dosimetric impact of DIBH versus free breathing (FB) on the heart and left anterior descending coronary artery (LAD).
- To evaluate RT planning techniques for left breast cancer patients.
Main Methods:
- Retrospective cohort study of 68 women with left-sided breast cancer receiving postoperative RT.
- RT planning was performed using both FB and DIBH techniques.
- Hypofractionated dose prescription (40.05 Gy in 15 fractions) was used.
Main Results:
- No significant difference in planning target volume (PTV) coverage between DIBH and FB.
- DIBH planning significantly reduced heart dose: median V16.8 Gy (0% vs 2.56%), V8.8 Gy (0% vs 3.47%), and mean heart dose (0.92 Gy vs 1.97 Gy).
- DIBH significantly reduced LAD dose: D2% < 42 Gy (median 5.8 Gy vs 34.87 Gy), V16.8 Gy < 10% (median 0% vs 15.87%), and mean LAD dose (2.92 Gy vs 8.13 Gy).
Conclusions:
- DIBH consistently reduces cardiac and LAD radiation dose.
- DIBH maintains target volume coverage in left breast cancer RT.
- DIBH is a superior technique for minimizing cardiac and LAD radiation exposure.
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