Highlights
- •FB-CCDps and FB-HCD correlated equally with DIBH induced mean heart dose reduction.
- •The ratio of FB-CCDps and FB-HCD was the strongest correlation with heart dose sparing.
- •A prediction model predicted 1.04 Gy heart dose reduction per unit of FB-CCDps/FB-HCD.
Abstract
This retrospective study of left breast radiation therapy (RT) investigates the correlation
between anatomical parameters and dose to heart or/and left lung in deep inspiration
breath-hold (DIBH) compared to free-breathing (FB) technique. Anatomical parameters
of sixty-seven patients, treated with a step-and-shoot technique to 50 Gy or 50.4 Gy
were included. They consisted of the cardiac contact distances in axial (CCDax) and parasagittal (CCDps) planes, and the lateral heart-to-chest distance (HCD). Correlation analysis was
performed to identify predictors for heart and lung dose sparing. Paired t-test and linear regression were used for data analysis with significance level of
p = 0.05. All dose metrics for heart and lung were significantly reduced with DIBH,
however 21% of patients analyzed had less than 1.0 Gy mean heart dose reduction. Both
FB-CCDpsdistance and FB-HCD correlated with FB mean heart dose and mean DIBH heart dose reduction.
The strongest correlation was observed for the ratio of FB-CCDps and FB-HCD with heart dose sparing. A FB-CCDps and FB-HCD model was developed to predict DIBH induced mean heart dose reduction,
with 1.04 Gy per unit of FB-CCDps/FB-HCD. Variation between predicted and actual mean heart dose reduction ranged from
−0.6 Gy to 0.6 Gy. In this study, FB-CCDps and FB-HCD distance served as predictors for heart dose reduction with DIBH equally,
with FB-CCDps/FB-HCD as a stronger predictor. These parameters and the prediction model could be
further investigated for use as a tool to better select patients who will benefit
from DIBH.
Keywords
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Article info
Publication history
Published online: October 17, 2019
Accepted:
September 25,
2019
Received in revised form:
September 10,
2019
Received:
April 28,
2019
Identification
Copyright
© 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
