A comparative dosimetric study between free-breathing and forced inspiration used radiotherapy 3D techniques in the left breast cancer

Autores

  • Mónica Duarte Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal
  • Vanessa Rodrigues Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal
  • Marco Caetano Departamento das Ciências do Diagnóstico, Terapêutica e Saúde Pública, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal
  • Paulo Fernandes Departamento das Ciências do Diagnóstico, Terapêutica e Saúde Pública, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal
  • Bartos Bak Radiotherapy Department II, Greater Poland Cancer Centre. Poznań, Poland

DOI:

https://doi.org/10.25758/set.486

Palavras-chave:

Left breast cancer, Radiotherapy, Free-breathing, Deep inspiration breath-hold, Left ventricle

Resumo

Introduction – Radiotherapy (RT) is a therapeutic approach for the treatment of left breast cancer. However, different breathing techniques free breathing (FB) and deep inspiration breath-hold (DIBH) can be used. Objectives – To identify which of the breathing techniques, DIBH or FB, has obtained better irradiation of the planning target volume (PTV) and a lower dose at the organs at risk (OAR). Check if the DIBH technique allows a dose reduction in the left ventricle. Methodology – Twenty female patients with pathology in the left breast were selected. In computed tomography, the contours of PTV and OAR were made. We obtained dosimetric data for each patient, with the two types of breathing techniques. Dosimetric data for all patients were compared for both respiratory methods. Results – The DIBH technique reduced the mean dose (Dmean) and V20% in the left lung, only being higher in four patients. In the left ventricle, there was a decrease in Dmean and V30% in all patients. The spinal cord in either DIBH or FB did not reach the reference limit, however, there was an improvement when using DIBH. Conclusions – The DIBH technique presents lower doses in the organs at risk, improvements in PTV dose coverage, and conformity, homogeneity, and quality indexes compared to the FB technique.

Downloads

Os dados de download ainda não estão disponíveis.

Referências

Oechsner M, Düsberg M, Borm KJ, Combs SE, Wilkens JJ, Duma MN. Deep inspiration breath-hold for left-sided breast irradiation: analysis of dose-mass histograms and the impact of lung expansion. Radiat Oncol. 2019;14(1):109.

Duane F, Aznar MC, Bartlett F, Cutter DJ, Darby SC, Jagsi R, et al. A cardiac contouring atlas for radiotherapy. Radiother Oncol. 2017;122(3):416-22.

Mkanna A, Mohamad O, Ramia P, Thebian R, Makki M, Tamim H, et al. Predictors of cardiac sparing in deep inspiration breath-hold for patients with left sided breast cancer. Front Oncol. 2018;8:564.

Al-Hammadi N, Caparrotti P, Naim C, Hayes J, Benson KR, Vasic A, et al. Voluntary deep inspiration breath-hold reduces the heart dose without compromising the target volume coverage during radiotherapy for left-sided breast cancer. Radiol Oncol. 2018;52(1):112-20.

Sardaro A, Petruzzelli MF, D’Errico MP, Grimaldi L, Pili G, Portaluri M. Radiation-induced cardiac damage in early left breast cancer patients: risk factors, biological mechanisms, radiobiology, and dosimetric constraints. Radiother Oncol. 2012;103(2):133-42.

Zhao F, Shen J, Lu Z, Luo Y, Yao G, Bu L, et al. Abdominal DIBH reduces the cardiac dose even further: a prospective analysis. Radiat Oncol. 2018;13(1):116.

IBM. SPSS statistics v. 23 documentation [homepage]. IBM; 2018 [updated 2018 Jun 17]. Available from: https://www.ibm.com/support/pages/ibm-spss-statistics-23-documentation

Fontelles MJ. Bioestatística aplicada à pesquisa experimental. Vol. 2. São Paulo: Editora Livraria da Física; 2012. ISBN 9788578611385

Feuvret L, Noël G, Mazeron JJ, Bey P. Conformity index: a review. Int J Radiat Oncol Biol Phys. 2006;64(2):333-42.

Kataria T, Sharma K, Subramani V, Karrthick KP, Bisht SS. Homogeneity index: an objective tool for assessment of conformal radiation treatments. J Med Phys. 2012;37(4):207-13.

Petrova D, Smickovska S, Lazarevska E. Conformity index and homogeneity index of the postoperative whole breast radiotherapy. Open Access Maced J Med Sci. 2017;5(6):736-9.

Shaw E, Kline R, Gillin M, Souhami L, Hirschfeld A, Dinapoli R. Radiation therapy oncology group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys. 1993;27(5):1231-9.

Borges C, Cunha G, Teixeira N. Comparação de diferentes técnicas de irradiação de mama em radioterapia com recurso a acelerador linear em modo de fotões [Comparison of different radiotherapy breast irradiation techniques in LINAC using photon mode]. Saúde Tecnol. 2013;(9):33-39 Portuguese

Pandeli C, Smyth LM, David S, See AW. Dose reduction to organs at risk with deep-inspiration breath-hold during right breast radiotherapy: a treatment planning study. Radiat Oncol. 2019;14(1):223.

Bentzen SM, Constine LS, Deasy JO, Eisbruch A, Jackson A, Marks LB, et al. Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S3-9.

Marks LB, Yorke ED, Jackson A, Haken RK, Constine LS, Eisbruch A, et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S10-9.

Ferreira MP. Análise do planning target volume e órgãos de risco, com diferentes energias de fotões em 3D-CRT, no cancro do pulmão [dissertation]. Porto: Escola Superior de Saúde, Instituto Politécnico do Porto; 2016.

Emami B. Tolerance of normal tissue to therapeutic radiation. Rep Radiother Oncol. 2013;1(1):123-7.

Czeremszyńska B, Drozda S, Górzyński M, Kępka L. Selection of patients with left breast cancer for deep-inspiration breath-hold radiotherapy technique: results of a prospective study. Rep Pract Oncol Radiother. 2017;22(5):341-8.

Hepp R, Ammerpohl M, Morgenstern C, Nielinger L, Erichsen P, Abdallah A, et al. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer: dosimetrical comparison and clinical feasibility in 20 patients. Strahlenther Onkol. 2015;191(9):710-6.

Latty D, Stuart KE, Wang W, Ahern V. Review of deep inspiration breath-hold techniques for the treatment of breast cancer. J Med Radiat Sci. 2015;62(1):74-81.

Valente AM. Comparação de irradiação de mama esquerda: inspiração forçada vs respiração livre [dissertation]. Lisboa: Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa; 2018.

Russo S, Rossi F, Paoletti L, Barca R, Fondelli S, Alpi P, et al. DIBH technique guided by an optical system in left breast irradiation. Phys Med. 2016;32(Suppl 3):197.

Korreman SS, Pedersen AN, Nøttrup TJ, Specht L, Nyström H. Breathing adapted radiotherapy for breast cancer: comparison of free breathing gating with the breath-hold technique. Radiother Oncol. 2005;76(3):311-8.

Comsa D, Barnett E, Le K, Mohamoud G, Zaremski D, Fenkell L, et al. Introduction of moderate deep inspiration breath hold for radiation therapy of left breast: initial experience of a regional cancer center. Pract Radiot Oncol. 2014;4(5):298-305.

Downloads

Publicado

01-06-2022

Edição

Secção

Artigos

Como Citar

A comparative dosimetric study between free-breathing and forced inspiration used radiotherapy 3D techniques in the left breast cancer. (2022). Saúde & Tecnologia, 26, 26-32. https://doi.org/10.25758/set.486