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Evaluation of an in-house self-held respiration monitoring device for deep inspiration breath hold techniques for radiotherapy of patients with cancer of the left breast

  • Yuen Yan Chan (a1), Ki Man Ku (a1), Yin Ping Ng (a1), Siu Ki Ben Yu (a2), Chi Wah Tony Kong (a2), Wing Lun Alan Mui (a1), Chun Man Cornel Wong (a1), Sze Wan Kong (a1), Sze Ming Wong (a1) and George Chiu (a1)...

Abstract

Background:

An in-house self-held respiration monitoring device (SHRMD) was developed for providing deep inspiration breath hold (DIBH) radiotherapy. The use of SHRMD is evaluated in terms of reproducibility, stability and heart dose reduction.

Methods and materials:

Sixteen patients receiving radiotherapy of left breast cancer were planned for treatment with both a free breathing (FB) scan and a DIBH scan. Both FB and DIBH plans were generated for comparison of the heart, left anterior descending (LAD) artery and lung dose. All patients received their treatments with DIBH using SHRMD. Megavoltage cine images were acquired during treatments for evaluating the reproducibility and stability of treatment position using SHRMD.

Results:

Compared with FB plans, the maximum dose to the heart by DIBH technique with SHRMD was reduced by 29·9 ± 15·6%; and the maximum dose of the LAD artery was reduced by 41·6 ± 18·3%. The inter-fractional overall mean error was 0·01 cm and the intra-fractional overall mean error was 0·04 cm.

Conclusion:

This study demonstrated the potential benefits of using the SHRMD for DIBH to reduce the heart and LAD dose. The patients were able to perform stable and reproducible DIBHs.

Copyright

Corresponding author

Author for correspondence: Yuen Yan Chan, Department of Radiotherapy, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong. Tel: 28358066. Fax: 28357509. E-mail: chloechanyy@gmail.com

References

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1. Darby, S, McGale, P, Correa, C et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials. Lancet 2011; 378 (9804): 17071716.
2. Darby, S C, Ewertz, M, McGale, P et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 2013; 368: 987998.
3. Taylor, C W, Nisbet, A, McGale, P, Darby, S C. Cardiac exposures in breast cancer radiotherapy: 1950s–1990s. Int J Radiat Oncol Biol Phys 2007; 69 (5): 14841495.
4. Sardaro, A, Petruzzelli, M F, D’Errico, M P, 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: 133142.
5. Bergom, C, Currey, A, Desai, N, Tai, A, Strauss, JB. Deep inspiration breath hold: techniques and advantages for cardiac sparing during breast cancer irradiation. Front Oncol 2018; 8: 87.
6. Borst, G R, Sonke, J J, den Hollander, S et al. Clinical results of image-guided deep inspiration breath hold breast irradiation. Int J Radiat Oncol Biol Phys 2010; 78 (5): 13451351.
7. Jarvis, L A, Maxim, P G, Horst, K C. Deep inspiration breath hold reduces dose to the left ventricle and proximal left anterior descending artery during radiotherapy for left-sided breast cancers. J Cancer Ther 2012; 5A (3): 673679.
8. Korreman, S S, Pedersen, A N, Nottrup, T J, Specht, L, Nystrom, H. Breathing adapted radiotherapy for breast cancer: comparison of free breathing gating with the breath-hold technique. Radiother Oncol 2005; 76 (3): 311318.
9. McIntosh, A, Shoushtari, A N, Benedict, S H, Read, P W, Wijesooriya, K. Quantifying the reproducibility of heart position during treatment and corresponding delivered heart dose in voluntary deep inhalation breath hold for left breast cancer patients treated with external beam radiotherapy. Int J Radiat Oncol Biol Phys 2011; 81(4): e569576.
10. Pedersen, A N, Korreman, S., Nystrom, H., Specht, L. Breathing adapted radiotherapy of breast cancer: reduction of cardiac and pulmonary doses using voluntary inspiration breath-hold. Radiother Oncol 2004; 72 (1): 5360.
11. Remouchamps, V M, Letts, N, Vicini, F A et al. Initial clinical experience with moderate deep-inspiration breath hold using an active breathing control device in the treatment of patients with left-sided breast cancer using external beam radiation therapy. Int J Radiat Oncol Biol Phys 2003; 56 (3): 704715.
12. Berson, A M, Emery, R, Rodriguez, L et al. Clinical experience using respiratory gated radiation therapy: comparison of free-breathing and breath-hold techniques. Int J Radiat Oncol Biol Phys 2004; 60 (2): 419426.
13. Latty, D, Stuart, K E, Wang, W, Ahern, V. Review of deep inspiration breath-hold techniques for the treatment of breast cancer. J Med Radiat Sci 2015; 62: 7481.
14. Smyth, L M, Knight, K A, Aarons, Y K, Wasiak, J. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review. J Med Radiat Sci 2015; 62: 6673.
15. Taylor, C W, Kirby, A M. Cardiac side-effects from breast cancer radiotherapy. Clin Oncol (R Coll Radiol) 2015; 27 (11): 621629.
16. Walston, S, Quick, A M, Kuhn, K, Rong, Y. Dosimetric considerations in respiratory-gated deep inspiration breath-hold for left breast irradiation. Technol Cancer Res Treat 2017;16 (1): 2232.
17. Swanson, T, Grills, I S, Ye, H et al. Six-year experience routinely using moderate deep inspiration breath-hold for the reduction of cardiac dose in left-sided breast irradiation for patients with early-stage or locally advanced breast cancer. Am J Clin Oncol 2013; 36: 2430.
18. Conway, J L, Conroy, L, Harper, L et al. Deep inspiration breath-hold produces a clinically meaningful reduction in ipsilateral lung dose during locoregional radiation therapy for some women with right-sided breast cancer. Pract Radiat Oncol 2017; 7: 147153.
19. Hayden, A J, Rains, M, Tiver, K. Deep inspiration breath hold technique reduces heart dose from radiotherapy for left-sided breast cancer. J Med Imaging Radiat Oncol 2012; 56: 464472.
20. Al-Hammadi, N, Caparrotti, P, Naim, C 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): 112120.
21. Jensen, C A, Abramova, T, Frengen, J, Lund, J. Monitoring deep inspiration breath hold for left-sided localized breast cancer radiotherapy with an in-house developed laser distance meter system. J Appl Clin Med Phys 2017; 18 (5): 117123.

Keywords

Evaluation of an in-house self-held respiration monitoring device for deep inspiration breath hold techniques for radiotherapy of patients with cancer of the left breast

  • Yuen Yan Chan (a1), Ki Man Ku (a1), Yin Ping Ng (a1), Siu Ki Ben Yu (a2), Chi Wah Tony Kong (a2), Wing Lun Alan Mui (a1), Chun Man Cornel Wong (a1), Sze Wan Kong (a1), Sze Ming Wong (a1) and George Chiu (a1)...

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