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Title: The cardiac dose-sparing benefits of deep inspiration breath-hold in the left breast irradiation: A systematic review
Epworth Authors: Smyth, Lloyd
Aarons, Yolanda
Wasiak, Jason
Other Authors: Knight, Kellie
Keywords: Adverse Effects
Breast Neoplasms
Breast Radiation Therapy
Cardiac Toxicities
Cardiac-Sparing Benefits
Deep Inspiration Breath-Hold
Epworth HealthCare, Richmond, Vic, Australia
Epworth Radiation Oncology
Issue Date: Mar-2015
Publisher: Wiley
Citation: J Med Radiat Sci. 2015 March; 62(1): 66–73.
Abstract: Introduction: Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. Methods: An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Results: Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. Conclusion: DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.
DOI: 10.1002/jmrs.89
PubMed URL:
ISSN: 2051-3909
Journal Title: Journal of Medical Radiation Sciences
Type: Journal Article
Affiliated Organisations: Department of Medical Imaging & Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing & Health Sciences, Monash University, Clayton, Victoria
Type of Clinical Study or Trial: Systematic Review
Appears in Collections:Cancer Services
Cardiac Sciences
Radiation Oncology

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