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Updated: May 25, 2025

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
Published on: July 3, 2014
A Systematic Review of Deep Inspiration Breath Hold and Free Breathing in Proton Beam Therapy Plans for Breast Cancer
F Wilson1, P Gupta2, H Halvorsen2
1Radiotherapy Related Research Group, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Patterson Building, Wilmslow Road, Manchester, M20 4BX, UK; The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.
Aims:
To conduct a systematic review of breast cancer radiotherapy studies reporting a comparison of proton beam therapy (PBT) in deep inspiration breath hold (DIBH) and in free breathing (FB).
Methods And Materials:
Studies comparing DIBH and FB proton beam therapy plans, in the same patient, published between 2015 and 2023 were included. Doses to organs at risk were compared between DIBH and FB plans.
Results:
Nine papers were identified for inclusion, reporting on 97 patients in total. All plans were for left-sided treatment. Average weighted mean heart dose was 0.31 Gy for DIBH and 0.48 Gy for FB. Average weighted mean left lung dose was 5.27 Gy for DIBH and 4.80 Gy for FB. Average weighted mean near maximum/maximum left anterior descending artery dose was 6.49 Gy for DIBH and 8.74 Gy for FB.
Conclusion:
Based on the current literature, it does not appear that DIBH offers a marked dosimetric benefit to most breast cancer patients treated with PBT. However, the benefits of combining PBT and DIBH for individual breast RT patients cannot be excluded.
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