Keywords:
Breast, Radioprotection / Radiation dose, Cardiac, CT, CT-High Resolution, Radiation therapy / Oncology, Complications, Radiation effects, Cancer, Dosimetric comparison, Image guided radiotherapy
Authors:
A. Parasuramar, M. Borg, A. DeSmit; SA/AU
DOI:
10.1594/ranzcr2017/R-0124
Conclusion
In our study consisting of 20 patients undergoing left sided breast cancer radiotherapy we showed that DIBH was a superior means of administering radiotherapy than free breathing.
This is consistent with the literature already present.
The treatment fields can be seen in Figures 5-8 demonstrating a reduced dose to organs-at-risk.
In addition to this we demonstrated that ABC (using Elekta equipment) was a superior breath hold technique when compared to VBH.
Statistically significant reductions were in Heart (Gy) and Contralateral Breast V3 (%).
Further studies with larger cohorts across mutliple centres are required to confirm these findings.
Exciting prospects include the use of SPECT scans to measure radiation related cardiotoxicity more accurately (19).
Additionally Mittauer et al.
has discussed using Optical Tracking Systems as a tool for real-time quality control of ABC-assisted DIBH (20).
This method will help increase precision and reproducibility of DIBH in turn reducing the irradiation of the heart.
Comparison of other breath-hold methods will help practitioners to select appropriate treatments amongst the myriad of options.
Long term follow-up is required to fully determine the clinical outcomes associated with irradiation to the heart and lung.
Additionally,
further research should help develop more stringent patient-selection criteria.
These studies should also target patient coaching and treatment verification protocols which will improve the efficiency and reproducibility of the technique.