Abstract

Background: Post-operative breast radiotherapy is used to reduce recurrence. The aim of this study was to investigate the outcomes of Deep Inspiration Breath-Hold (DIBH) technique with indigenous breath holding indicator scale in 3DCRT for breast cancer radiotherapy over Free Breathing (FB) technique. Methods: An observational study conducted at the Department of Radiation Oncology at National Institute of Cancer Research and Hospital, Dhaka and Square Hospital Limited, Dhaka, Bangladesh from June 2015 to May 2016. A total of 60 confirmed breast cancer patients who underwent adjuvant radiotherapy were included. An indigenous reproducible plastic tool (Perspex) was used as breath holding indicator scale with DIBH technique in 3DCRT. Paired sample t-test was used to compare with FB technique. Results: The mean age of patients was 47.32 (SD ± 8.33) years. In FB technique, Mean Heart Dose (MHD) was 413.27 cGy while in DIBH technique, it was 254.91 cGy (P and V30 were 5.5%, 4.37% in FB and 3.13%, 2.36% in DIBH respectively. In FB technique LADMD, LAD 0.2 cm3, ILMD and ILV20 were 1698.17 cGy, 2852.53 cGy, 1155.31 cGy and 28.62% while in DIBH technique, it was reduced to 1164.01 cGy, 2132.24 cGy, 1007.98 cGy and 23.39% respectively. Similarly, the lung-CLMD and breast-CLMD were reduced from 38.37 cGy and 55.18 cGy to 24.64 cGy and 33.82 cGy respectively (P Conclusion: The use of indigenous breath holding indicator scale with DIBH had better outcomes on breast cancer radiotherapy.

Highlights

  • With the advances of mammography, breast cancer is being detected at an earlier stage preventing spread as well as supporting in rapid cure [1]

  • The aim of this study was to investigate the outcomes of Deep Inspiration Breath-Hold (DIBH) technique with indigenous breath holding indicator scale in 3DCRT for breast cancer radiotherapy over Free Breathing (FB) technique

  • We found breast cancer patients of either side who needed adjuvant radiotherapy

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Summary

Introduction

With the advances of mammography, breast cancer is being detected at an earlier stage preventing spread as well as supporting in rapid cure [1]. Several studies reported an appreciable reduction in cardiac volume within tangential radiation portals for left-sided breast cancer through deep inspiration using breath-hold techniques or forced breath-hold [4] [5] [6] [7] [8]. They reported on pulmonary tissue sparing for both left and right-sided cancers [6] [8]. The aim of this study was to investigate the outcomes of Deep Inspiration Breath-Hold (DIBH) technique with indigenous breath holding indicator scale in 3DCRT for breast cancer radiotherapy over Free Breathing (FB) technique.

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