Abstract
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. 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). Quantitative statistical analysis of plan dose differences was performed. Lung dose was not affected by DIBH. Heart Dmax reduced by 34.5% (FB=41.81Gy, SD=3.963Gy vs. DIBH=27.39Gy, SD=12.393Gy, p<0.000004). Heart Dmean reduced by 32.6% (FB=1.817Gy, SD=0.627Gy vs. DIBH=1.224Gy, SD=0.344Gy, p=0.00000083067. LADCA Dmax reduced by 47.8% (DIBH mean=15.56Gy, SD=10.62Gy vs. FB mean=29.82Gy, SD=10.05Gy, p=0.000031, and LADCA Dmean by 52% (DIBH mean=5.23Gy, SD=1.94Gy vs. FB mean=10.88Gy, SD=3.95Gy p=0.000000036027. Amplitude depths were not correlated with dose reductions. DIBH significantly reduces heart and LADCA dose. Further research is required to evaluate potential long-term implications for patients treated DIBH.
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