Deep Inspiration Breath Hold Reduces Dose to the Left Ventricle and Proximal Left Anterior Descending Artery during Radiotherapy for Left-Sided Breast CancersReport as inadecuate




Deep Inspiration Breath Hold Reduces Dose to the Left Ventricle and Proximal Left Anterior Descending Artery during Radiotherapy for Left-Sided Breast Cancers - Download this document for free, or read online. Document in PDF available to download.

The purpose of this study was to analyze motion of the left anterior descending coronary artery LAD and left ventricle during normal breathing and deep inspiration breath hold DIBH. This is a dosimetric study utilizing free-breathing and static DIBH scans from eleven patients treated with radiotherapy for breast cancer. The anterior-posterior displacement along the length of the LAD was measured in each respiratory phase. Standard treatment plans targeting the whole breast without treatment of the internal mammary lymph nodes were generated and dose to the LAD and LV calculated. Non-uniform movement of the LAD during respiratory maneuvers with the proximal third exhibiting the greatest displacement was observed. In DIBH compared to end-expiration EP, the mean posterior displacement of the proximal 1-3 of the LAD was 8.99 mm, the middle 1-3 of the artery was 6.37 mm, and the distal 1-3 was 3.27 mm. In end-inspiration IP compared to end-expiration the mean posterior displacements of the proximal 1-3 of the LAD was 2.08 mm, the middle 1-3 of the artery was 0.91 mm, and the distal 1-3 was 0.97 mm. Mean doses to the LAD using tangential treatment fields and a prescribed dose of 50.4 Gy were 11.32 Gy in EP, 8.98 Gy in IP, and 3.50 Gy in DIBH. Mean doses to the LV were 2.38 Gy in EP, 2.31 Gy in IP, and 1.24 Gy in DIBH. In conclusion, inspiration and especially DIBH, cause a displacement of the origin and proximal 2-3 of the LAD away from the chest wall, resulting in sparing of the most critical segment of the artery during tangential radiotherapy.

KEYWORDS

Breast, Radiotherapy; Deep-Inspiration Breath Hold DIBH; Respiratory Gating; Left Anterior Descending Artery LAD; Left Ventricle LV

Cite this paper

L. A. Jarvis, P. G. Maxim and K. C. Horst -Deep Inspiration Breath Hold Reduces Dose to the Left Ventricle and Proximal Left Anterior Descending Artery during Radiotherapy for Left-Sided Breast Cancers,- Journal of Cancer Therapy, Vol. 3 No. 5A, 2012, pp. 673-679. doi: 10.4236-jct.2012.325087.





Author: Lesley A. Jarvis, Peter G. Maxim, Kathleen C. Horst

Source: http://www.scirp.org/



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