Trial reportRadiation oncology (London, England)2015
Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.
Trial report in Radiation oncology (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
54 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cardiorespiratory dose comparison among six radiotherapy regimens for patients with left-sided breast cancer.Scientific reports · 2023Pooled it
- A randomized trial of early cardiotoxicity in breast cancer patients receiving postoperative IMRT with or without serial cardiac dose constraints.International journal of cancer · 2025Trial
- Reproducibility of repeated breathhold and impact of breathhold failure in whole breast and regional nodal irradiation in prone crawl position.Scientific reports · 2022Trial
- CPAP (Continuous Positive Airway Pressure) is an effective and stable solution for heart sparing radiotherapy of left sided breast cancer.Radiation oncology (London, England) · 2020Trial
- Review
- Clinical evaluation using first-day assessment of patient suitability for successful performance of deep inspiration breath-hold for breast cancer radiotherapy.Radiation oncology (London, England) · 2026Article
- Cardiovascular care in adult cancer survivorship post-therapy: a cross-sectional analysis of clinical practice guidelines.Cardio-oncology (London, England) · 2026Review
- Clinical Predictors of Dosimetric Precedence for Deep Inspiratory Breath Hold Radiation Therapy for Breast Cancer.Diagnostics (Basel, Switzerland) · 2026Article
- Patient coaching for deep inspiration breath hold decreases set-up duration and left anterior descending artery dose for left-sided breast cancer radiotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Reduction of subclinical acute cardiac injury through DIBH radiotherapy: a single-institution real-world clinical cohort analysis.BMC cancer · 2025Article
- Cardiovascular Considerations During Cancer Therapy: Gaps in Evidence andJACC. CardioOncology · 2024Review
- Dosimetric benefit and clinical feasibility of deep inspiration breath-hold and volumetric modulated arc therapy-based postmastectomy radiotherapy for left-sided breast cancer.Scientific reports · 2024Article
- Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Comparing breath hold versus free breathing irradiation for left-sided breast radiotherapy by PlanIQ™.Radiation oncology (London, England) · 2023Article
- Article
- Dosimetric Evaluation of Cardiac Structures on Left Breast Cancer Radiotherapy: Impact of Movement, Dose Calculation Algorithm and Treatment Technique.Cardiology research · 2023Article
- Article
- Proton Therapy for Bilateral Breast Cancer Maximizes Normal-Tissue Sparing.International journal of particle therapy · 2023Article
- Mediators of Racial Disparities in Heart Dose Among Whole Breast Radiotherapy Patients.Journal of the National Cancer Institute · 2022Article
- Retrospective Analysis for Dose Reduction to Organs at Risk with New Personalized Breast Holder (PERSBRA) in Left Breast IMRT.Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDeep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean < 4 Gy in these two cohorts.
methodsTwenty consecutive patients underwent CT simulation both free breathing (FB) and DIBH. Patients were grouped into two cohorts: WBRT (n = 11) and B/CWRT + RNI (n = 9). 3D-conformal plans were developed and FB was compared to DIBH for each cohort using Wilcoxon signed-rank tests for continuous variables and McNemar's test for discrete variables. The percent relative reduction conferred by DIBH in mean heart and LAD dose, as well as lung V20 were compared between the two cohorts using Wilcox rank-sum testing. The significance level was set at 0.05 with Bonferroni correction for multiple testing.
resultsAll patients had comparable target coverage on DIBH and FB. DIBH statistically significantly reduced mean heart and LAD dose for both cohorts. Percent reduction in mean heart and LAD dose with DIBH was significantly larger in the B/CWRT + RNI cohort compared to WBRT group (relative reduction in mean heart and LAD dose: 55.9 % and 72.1 % versus 29.2 % and 43.5 %, p < 0.02). All patients in the WBRT group and five patients (56 %) in the B/CWBRT + RNI group met heart Dmean <4 Gy with FB. All patients met this constraint with DIBH.
conclusionsAll patients receiving WBRT met Dmean Heart < 4 Gy on FB, while only slightly over half of patients receiving B/CWRT + RNI were able to meet this constraint in FB. DIBH allowed a greater reduction in mean heart and LAD dose in patients receiving B/CWRT + RNI, including IMC nodes than patients receiving WBRT. These findings suggest greatest benefit from DIBH treatment for patients receiving regional nodal irradiation.
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