Dosimetric and clinical advantages of deep inspiration breath-hold DIBH during radiotherapy of breast cancerReportar como inadecuado

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Journal of Experimental and Clinical Cancer Research

, 32:88

First Online: 07 November 2013Received: 05 August 2013Accepted: 29 October 2013DOI: 10.1186-1756-9966-32-88

Cite this article as: Bruzzaniti, V., Abate, A., Pinnarò, P. et al. J Exp Clin Cancer Res 2013 32: 88. doi:10.1186-1756-9966-32-88


BackgroundTo investigate the potential dosimetric and clinical benefits of Deep Inspiration Breath-Hold DIBH technique during radiotherapy of breast cancer compared with Free Breathing FB.

MethodsEight left-sided breast cancer patients underwent a supervised breath hold during treatment. For each patient, two CT scans were acquired with and without breath hold, and virtual simulation was performed for conventional tangential fields, utilizing 6 or 15 MV photon fields. The resulting dose–volume histograms were calculated, and the volumes of heart-lung irradiated to given doses were assessed. The left anterior descending coronary artery LAD mean and maximum doses were calculated, together with tumour control probability TCP and normal tissue complication probabilities NTCP for lung and heart.

ResultsFor all patients a reduction of at least 16% in lung mean dose and at least 20% in irradiated pulmonary volumes was observed when DIBH was applied. Heart and LAD maximum doses were decreased by more than 78% with DIBH. The NTCP values for pneumonitis and long term cardiac mortality were also reduced by about 11% with DIBH. The NTCP values for pericarditis were zero for both DIBH and FB.

ConclusionDelivering radiation in DIBH conditions the dose to the surrounding normal structures could be reduced, in particular heart, LAD and lung, due to increased distance between target and heart, and to reduced lung density.

KeywordsDeep inspiration breath-hold gating radiotherapy Breast cancer radiotherapy NTCP TCP Electronic supplementary materialThe online version of this article doi:10.1186-1756-9966-32-88 contains supplementary material, which is available to authorized users.

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Autor: Vicente Bruzzaniti - Armando Abate - Paola Pinnarò - Marco D’Andrea - Erminia Infusino - Valeria Landoni - Antonella Sor


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