Predictors of cardiac and lung dose sparing in DIBH for left breast treatment

被引：27
作者：
Cao, Ning [1 ,2 ]
Kalet, Alan M. [1 ,2 ]
Young, Lori A. [1 ,2 ]
Fang, L. Christine [1 ,2 ]
Kim, Janice N. [1 ,2 ]
Mayr, Nina A. [1 ,2 ]
Meyer, Juergen [1 ,2 ]
机构：
[1] Univ Washington, Dept Radiat Oncol, Seattle, WA 98195 USA
[2] Seattle Canc Care Alliance, Dept Radiat Oncol, Seattle, WA USA
来源：
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS | 2019年 / 67卷
关键词：
DIBH; Breast cancer; Cardiac and lung dose sparing; Calypso surface transponder; Predictors; MODULATED RADIATION-THERAPY; HOLD TECHNIQUE; HEART-DISEASE; CHEST-WALL; CANCER; RADIOTHERAPY; WOMEN; RISK; IRRADIATION; EXPOSURE;
D O I：
10.1016/j.ejmp.2019.09.240
中图分类号：
R8 [特种医学]; R445 [影像诊断学];
学科分类号：
1002 ; 100207 ; 1009 ;
摘要：
This retrospective study of left breast radiation therapy (RT) investigates the correlation between anatomical parameters and dose to heart or/and left lung in deep inspiration breath-hold (DIBH) compared to free-breathing (FB) technique. Anatomical parameters of sixty-seven patients, treated with a step-and-shoot technique to 50 Gy or 50.4 Gy were included. They consisted of the cardiac contact distances in axial (CCDax) and parasagittal (CCDps) planes, and the lateral heart-to-chest distance (HCD). Correlation analysis was performed to identify predictors for heart and lung dose sparing. Paired t-test and linear regression were used for data analysis with significance level of p = 0.05. All dose metrics for heart and lung were significantly reduced with DIBH, however 21% of patients analyzed had less than 1.0 Gy mean heart dose reduction. Both FB-CCDps distance and FB-HCD correlated with FB mean heart dose and mean DIBH heart dose reduction. The strongest correlation was observed for the ratio of FB-CCDps and FB-HCD with heart dose sparing. A FB-CCDps and FB-HCD model was developed to predict DIBH induced mean heart dose reduction, with 1.04 Gy per unit of FB-CCDps/FB-HCD. Variation between predicted and actual mean heart dose reduction ranged from - 0.6 Gy to 0.6 Gy. In this study, FB-CCDps and FB-HCD distance served as predictors for heart dose reduction with DIBH equally, with FB-CCDps/FB-HCD as a stronger predictor. These parameters and the prediction model could be further investigated for use as a tool to better select patients who will benefit from DIBH.
引用
收藏
页码：27 / 33
页数：7
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