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https://www.readbyqxmd.com/read/28916844/left-sided-breast-cancer-and-risks-of-secondary-lung-cancer-and-ischemic-heart-disease-effects-of-modern-radiotherapy-techniques
#1
Stefanie Corradini, Hendrik Ballhausen, Helmut Weingandt, Philipp Freislederer, Stephan Schönecker, Maximilian Niyazi, Cristoforo Simonetto, Markus Eidemüller, Ute Ganswindt, Claus Belka
PURPOSE: Modern breast cancer radiotherapy techniques, such as respiratory-gated radiotherapy in deep-inspiration breath-hold (DIBH) or volumetric-modulated arc radiotherapy (VMAT) have been shown to reduce the high dose exposure of the heart in left-sided breast cancer. The aim of the present study was to comparatively estimate the excess relative and absolute risks of radiation-induced secondary lung cancer and ischemic heart disease for different modern radiotherapy techniques. METHODS: Four different treatment plans were generated for ten computed tomography data sets of patients with left-sided breast cancer, using either three-dimensional conformal radiotherapy (3D-CRT) or VMAT, in free-breathing (FB) or DIBH...
September 15, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28838605/life-years-lost-attributable-to-late-effects-after-radiotherapy-for-early-stage-hodgkin-lymphoma-the-impact-of-proton-therapy-and-or-deep-inspiration-breath-hold
#2
Laura Ann Rechner, Maja Vestmø Maraldo, Ivan Richter Vogelius, Xiaorong Ronald Zhu, Bouthaina Shbib Dabaja, Nils Patrik Brodin, Peter Meidahl Petersen, Lena Specht, Marianne Camille Aznar
BACKGROUND AND PURPOSE: Due to the long life expectancy after treatment, the risk of late effects after radiotherapy (RT) is of particular importance for patients with Hodgkin lymphoma (HL). Both deep inspiration breath hold (DIBH) and proton therapy have been shown to reduce the dose to normal tissues for mediastinal HL, but the impact of these techniques in combination is unknown. The purpose of this study was to compare the life years lost (LYL) attributable to late effects after RT for mediastinal HL using intensity modulated radiation therapy (IMRT) in free breathing (FB) and DIBH, and proton therapy in FB and DIBH...
August 21, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28755403/monitoring-deep-inspiration-breath-hold-for-left-sided-localized-breast-cancer-radiotherapy-with-an-in-house-developed-laser-distance-meter-system
#3
Christer A Jensen, Tatiana Abramova, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath hold (DIBH) in left-sided breast cancer radiotherapy is a technique to reduce cardiac and pulmonary doses while maintaining target coverage. This study aims at evaluating an in-house developed DIBH system. Free-breathing (FB) and DIBH plans were generated for 22 left-sided localized breast cancer patients who had radiation therapy (RT) after breast-conserving surgery. All patients were treated utilizing an in-house laser distance measuring system. 50 Gy was prescribed, and parameters of interest were target coverage, left anterior descending coronary artery, (LAD) and heart doses...
July 29, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28734644/postmastectomy-radiation-therapy-technique-and-cardiopulmonary-sparing-a-dosimetric-comparative-analysis-between-photons-and-protons-with-free-breathing-versus-deep-inspiration-breath-hold
#4
Sagar A Patel, Hsiao-Ming Lu, Jacqueline A Nyamwanda, Rachel B Jimenez, Alphonse G Taghian, Shannon M MacDonald, Nicolas Depauw
PURPOSE: Dosimetric studies have suggested greater cardiopulmonary sparing with protons over photons for left-sided postmastectomy radiation therapy (PMRT). Modern techniques such as deep inspiration breath hold (DIBH) can help spare the heart. This analysis compares photon and proton delivery with and without DIBH. METHODS AND MATERIALS: Ten women with left breast cancer referred for PMRT on a prospective clinical trial with unfavorable cardiac anatomy underwent free breathing (FB) and DIBH computed tomography simulation...
June 21, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28701900/selection-of-patients-with-left-breast-cancer-for-deep-inspiration-breath-hold-radiotherapy-technique-results-of-a-prospective-study
#5
Beata Czeremszyńska, Stanisław Drozda, Michał Górzyński, Lucyna Kępka
AIM: To assess prospectively which patients with left breast cancer have the dosimetric benefit from the use of deep-inspiration breath-hold radiotherapy (DIBH-RT). BACKGROUND: Improvement in selection of patients for DIBH-RT would spare time of radiotherapy staff by removing the need for preparation of two comparative treatment plans. MATERIALS AND METHODS: Thirty-one patients qualified for whole left breast irradiation underwent breath-hold training and their free-breathing (FB) and DIBH planning-CT were included in the analysis of dosimetric outcome...
September 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28652810/an-effective-deep-inspiration-breath-hold-radiotherapy-technique-for-left-breast-cancer-impact-of-post-mastectomy-treatment-nodal-coverage-and-dose-schedule-on-organs-at-risk
#6
Lynsey Rice, Christy Goldsmith, Melanie Ml Green, Susan Cleator, Patricia M Price
BACKGROUND: We developed, applied, and prospectively evaluated a novel deep-inspiration breath-hold (DIBH) screening and delivery technique to optimize cardiac sparing in left-breast radiotherapy (RT) at our clinic. The impact of set-up and dose variables upon organs at risk (OAR) dose in DIBH RT was investigated. METHODS AND MATERIALS: All patients with left-breast cancer referred between 2011 and 2014 - of all disease stages, set-up variations, and dose prescriptions - were included...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28646251/cardiac-dose-sparing-effects-of-deep-inspiration-breath-hold-in-left-breast-irradiation-is-imrt-more-beneficial-than-vmat
#7
Mazen Sakka, Leonie Kunzelmann, Martin Metzger, Gerhard G Grabenbauer
BACKGROUND: Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT)...
June 23, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28462867/monte-carlo-dose-calculation-in-presence-of-low-density-media-application-to-lung-sbrt-treated-during-dibh
#8
S Beilla, T Younes, L Vieillevigne, M Bardies, X Franceries, L Simon
PURPOSE: Commercial algorithms used in Radiotherapy include approximations that are generally acceptable. However their limits can be seen when confronted with small fields and low-density media. These conditions exist during the treatment of lung cancers with Stereotactic Body Radiation Therapy (SBRT) achieved with the "Deep Inspiration Breath Hold" (DIBH) technique. A Monte Carlo (MC) model of a linear accelerator was used to assess the performance of two algorithms (Varian Acuros and AAA) in these conditions...
April 24, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28432730/assessment-of-voluntary-deep-inspiration-breath-hold-with-cine-imaging-for-breast-radiotherapy
#9
Reuben Patrick Estoesta, Lani Attwood, Diana Naehrig, Elizabeth Claridge-Mackonis, David Odgers, Darren Martin, Melissa Pham, Joanne Toohey, Susan Carroll
Deep Inspiration Breath-Hold (DIBH) techniques for breast cancer radiation therapy (RT) have reduced cardiac dose compared to Free Breathing (FB). Recently, a voluntary deep inspiration breath-hold (vDIBH) technique was established using in-room lasers and skin tattoos to monitor breath-hold. An in-house quality assessment of positional reproducibility during RT delivery with vDIBH in patients with left-sided breast cancer was evaluated. The electronic portal imaging device (EPID) was used in cinematographic (CINE) mode to capture a sequence of images during beam delivery...
April 22, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28333011/utility-of-deep-inspiration-breath-hold-for-left-sided-breast-radiation-therapy-in-preventing-early-cardiac-perfusion-defects-a-prospective-study
#10
Timothy M Zagar, Orit Kaidar-Person, Xiaoli Tang, Ellen E Jones, Jason Matney, Shiva K Das, Rebecca L Green, Arif Sheikh, Amir H Khandani, William H McCartney, Jorge Daniel Oldan, Terence Z Wong, Lawrence B Marks
PURPOSE: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). METHODS AND MATERIALS: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK)...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28297275/how-dose-sparing-of-cardiac-structures-correlates-with-in-field-heart-volume-and-sternal-displacement
#11
Taeho Kim, Kelli Reardon, Daniel M Trifiletti, Constance Geesey, Kaitlyn Sukovich, Edwin Crandley, Paul W Read, Krishni Wijesooriya
Cardiac irradiation increases the risk of coronary artery disease in patients with left-sided breast cancer. Techniques exist to reduce cardiac irradiation, but the optimum technique depends on individual patient anatomy and physiology. We investigated the correlation of delta heart volume in field (dHVIF) and sternal excursion with dose sparing in heart and left anterior descending artery (LAD) to develop quantitative predictive models for expected dose to heart and LAD. A treatment planning study was performed on 97 left-breast cancer patients who underwent whole breast radiotherapy (prescription dose = 50 Gy) under deep inspiratory breath hold (DIBH)...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296326/evaluation-of-target-and-cardiac-position-during-visually-monitored-deep-inspiration-breath-hold-for-breast-radiotherapy
#12
Leigh Conroy, Rosanna Yeung, Elizabeth Watt, Sarah Quirk, Karen Long, Alana Hudson, Tien Phan, Wendy L Smith
A low-resource visually monitored deep inspiration breath-hold (VM-DIBH) technique was successfully implemented in our clinic to reduce cardiac dose in left-sided breast radiotherapy. In this study, we retrospectively characterized the chest wall and heart positioning accuracy of VM-DIBH using cine portal images from 42 patients. Central chest wall position from field edge and in-field maximum heart distance (MHD) were manually measured on cine images and compared to the planned positions based on the digitally reconstructed radiographs (DRRs)...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28291926/development-of-a-deep-inspiration-breath-hold-system-for-radiotherapy-utilizing-a-laser-distance-measurer
#13
Christer Andre Jensen, Nils Skottner, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath-hold (DIBH) is a technique for treating left-sided breast cancer (LSBC). In modern radiotherapy, one of the main aims is to exclude the heart from the beam aperture with an individualized beam design for LSBC. A deep inhalation will raise the chest wall while the volume of the lungs increase, this will again push the heart away from the breast to be treated. There are a few commercial DIBH systems, both invasive and noninvasive. We present an alternative noninvasive DIBH system based upon an industrial laser distance measurer...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28281859/geometrical-uncertainty-of-heart-position-in-deep-inspiration-breath-hold-radiotherapy-of-left-sided-breast-cancer-patients
#14
Tuomas Koivumäki, Juuso Tujunen, Tuomas Virén, Janne Heikkilä, Jan Seppälä
BACKGROUND: This study aimed to determine the geometrical uncertainty of the position of the heart with daily cone beam computed tomography (CBCT) during deep-inspiration breath-hold (DIBH) treatment of the left breast. MATERIAL AND METHODS: A visually guided optical respiratory monitoring system was used in DIBH treatment of 15 breast cancer patients. Heart position was determined in relation to the planning target volume (PTV) in 225 fractions in which daily low-dose CBCT images were compared with planning CT images...
March 10, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28274398/lower-mean-heart-dose-with-deep-inspiration-breath-hold-whole-breast-irradiation-compared-with-brachytherapy-based-accelerated-partial-breast-irradiation-for-women-with-left-sided-tumors
#15
COMPARATIVE STUDY
Emma B Holliday, Steve M Kirsner, Howard D Thames, Bryan E Mason, Christopher L Nelson, Elizabeth S Bloom
PURPOSE: For left-sided breast cancer, radiation to the heart is a concern. We present a comparison of mean heart and coronary artery biologically effective dose (BED) between accelerated partial breast irradiation (APBI) and whole breast irradiation with deep inspiration breath-hold technique (DIBH-WBI). METHODS AND MATERIALS: A total of 100 patients with left-sided, early-stage breast cancer were identified. Fifty underwent single-entry catheter-based APBI and 50 underwent DIBH-WBI...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28245908/target-position-uncertainty-during-visually-guided-deep-inspiration-breath-hold-radiotherapy-in-locally-advanced-lung-cancer
#16
Jonas Scherman Rydhög, Steen Riisgaard de Blanck, Mirjana Josipovic, Rasmus Irming Jølck, Klaus Richter Larsen, Paul Clementsen, Thomas Lars Andersen, Per Rugaard Poulsen, Gitte Fredberg Persson, Per Munck Af Rosenschold
PURPOSE: The purpose of this study was to estimate the uncertainty in voluntary deep-inspiration breath-hold (DIBH) radiotherapy for locally advanced non-small cell lung cancer (NSCLC) patients. METHODS: Perpendicular fluoroscopic movies were acquired in free breathing (FB) and DIBH during a course of visually guided DIBH radiotherapy of nine patients with NSCLC. Patients had liquid markers injected in mediastinal lymph nodes and primary tumours. Excursion, systematic- and random errors, and inter-breath-hold position uncertainty were investigated using an image based tracking algorithm...
February 25, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28203163/is-the-deep-inspiration-breath-hold-technique-superior-to-the-free-breathing-technique-in-cardiac-and-lung-sparing-while-treating-both-left-sided-post-mastectomy-chest-wall-and-supraclavicular-regions
#17
Anupama Darapu, Rajesh Balakrishnan, Patricia Sebastian, Mohamathu Rafic Kather Hussain, Paul Ravindran, Subhashini John
AIMS: To evaluate the efficacy of the deep inspirational breath-hold (DIBH) technique and its dosimetric advantages over the free breathing (FB) technique in cardiac (heart and left anterior descending artery [LAD]) and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. MATERIALS AND METHODS: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28188697/a-case-study-evaluating-deep-inspiration-breath-hold-and-intensity-modulated-radiotherapy-to-minimise-long-term-toxicity-in-a-young-patient-with-bulky-mediastinal-hodgkin-lymphoma
#18
Jonathan M Tomaszewski, Sarah Crook, Kenneth Wan, Lucille Scott, Farshad Foroudi
Radiotherapy plays an important role in the treatment of early-stage Hodgkin lymphoma, but late toxicities such as cardiovascular disease and second malignancy are a major concern. Our aim was to evaluate the potential of deep inspiration breath-hold (DIBH) and intensity-modulated radiotherapy (IMRT) to reduce cardiac dose from mediastinal radiotherapy. A 24 year-old male with early-stage bulky mediastinal Hodgkin lymphoma received involved-site radiotherapy as part of a combined modality programme. Simulation was performed in free breathing (FB) and DIBH...
March 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28179347/dose-sparing-potential-of-deep-inspiration-breath-hold-technique-for-left-breast-cancer-radiotherapy-organs-at-risk
#19
Gavin Lawler, Michelle Leech
BACKGROUND/AIM: To assess if deep inspiration breath-hold (DIBH) technique achieved dose sparing for organs-at-risk in left breast radiotherapy patients in order to reduce long-term complications. PATIENTS AND METHODS: DIBH and Free-breathing (FB) as a control, CT planning scans obtained for 28 left breast/chest wall (+/- supraclavicular field) patients treated January 2008-December 2013 were retrospectively re-contoured and re-planned. Organs-at-risk examined: lungs, left lung, heart and left anterior descending coronary artery (LADCA)...
February 2017: Anticancer Research
https://www.readbyqxmd.com/read/28139381/assessment-of-upfront-selection-criteria-to-prioritise-patients-for-breath-hold-left-sided-breast-radiotherapy
#20
COMPARATIVE STUDY
N Tanna, R McLauchlan, S Karis, C Welgemoed, D M Gujral, S J Cleator
AIMS: Deep inspiratory breath-hold (DIBH) techniques for left breast and chest wall radiotherapy can reduce cardiac dose. We investigated the use of 'upfront selection' criteria for DIBH based on tumour bed position and whether cardiac shielding was used. MATERIALS AND METHODS: Four methods of selecting patients for DIBH were assessed retrospectively in a cohort of left breast and chest wall treatments. These were: (1) free breathing scan on all patients, selecting DIBH treatment for those with a predicted mean heart dose ≥3 Gy; (2) selective DIBH for those with maximum heart depth (MHD) on free breathing scan ≥1 cm; (3) use of an 'upfront selection process' using tumour bed position as initial selection and measurement of MHD on those not selected upfront; (4) DIBH on all...
June 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
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