ReviewStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2019
Heart-sparing radiotherapy techniques in breast cancer patients: a recommendation of the breast cancer expert panel of the German society of radiation oncology (DEGRO).
Review in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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
71 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Post-neoadjuvant treatment with capecitabine and trastuzumab emtansine in breast cancer patients-sequentially, or better simultaneously?Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Pooled it
- Comparison Between Breath-Hold and the Inspiratory Phase of Free Breathing in Left Breast Cancer Radiotherapy: Target Volume Coverage and Organ Sparing.Asian Pacific journal of cancer prevention : APJCP · 2025Trial
- Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Trial
- Adjuvant hypofractionated radiotherapy with simultaneous integrated boost after breast-conserving surgery: results of a prospective trial.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Trial
- Adjuvant breast inversely planned intensity-modulated radiotherapy with simultaneous integrated boost for early stage breast cancer : Results from a phase II trial.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Trial
- Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks.Radiation oncology (London, England) · 2020Trial
- Review
- How reliable is deep inspiration breath hold at CT simulation? Clinical impact of surface-guided breathing training in breast cancer radiotherapy.Radiation oncology (London, England) · 2026Article
- Deformable image registration accuracy: impact of user-defined parameter selection on contour propagation for deep inspiration breath-hold and free breathing breast radiotherapy.BMC medical imaging · 2026Article
- Development of a model to guide the decision for radiotherapy in deep-inspiration breath-hold in patients with left-sided breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Progress for RAD18's mechanism in breast cancer radioresistant.Open life sciences · 2026Review
- Translating SGRT from Breast to Lung Cancer: A Study on Frameless Immobilization and Real-Time Monitoring Efficacy, Focusing on Setup Accuracy.Life (Basel, Switzerland) · 2025Article
- Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials.Clinical and translational radiation oncology · 2025Article
- Automated contouring for breast cancer radiotherapy in the isocentric lateral decubitus position: a neural network-based solution for enhanced precision and efficiency.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Optimizing Dose Reduction to the Left Anterior Descending Artery in Patients With Locally Advanced Lung Cancer Treated With Definitive Radiation Therapy: A Feasibility Study of Coplanar Treatments Using Double-Stacked Multileaf Collimator.Advances in radiation oncology · 2025Article
- Partial Breast Reirradiation for Breast Cancer Recurrences After Repeat Breast-Conserving Surgery with Proton Beam Therapy: The Prospective BREAST Trial (NCT06954623).Journal of clinical medicine · 2025Article
- Cardiac Effects of Modern Breast Radiation Therapy in Patients Receiving Systemic Cancer Therapy.JACC. CardioOncology · 2025Article
- Is intensive training with a time interval between instruction and planning CT necessary for deep inspiration breath-hold radiotherapy in breast cancer?Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Coronary artery calcium and cardiovascular risk factors analysis after radiotherapy for breast cancer (the CLARIFIER: a gender-based preventive medicine study).Frontiers in cardiovascular medicine · 2025Article
- Surface-based deep inspiration breath-hold radiotherapy in left-sided breast cancer: final results from the SAVE-HEART study.ESMO open · 2024Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this review was to analyze the respective efficacy of various heart-sparing radiotherapy techniques. MATERIAL AND
methodsHeart-sparing can be performed in three different ways in breast cancer radiotherapy: by seeking to keep the heart out of treated volumes (i.e. by prone position or specific breathing techniques such as deep inspiration breath-hold [DIBH] and/or gating), by solely irradiating a small volume around the lumpectomy cavity (partial breast irradiation, PBI), or by using modern radiation techniques like intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) or protons. This overview presents the available data on these three approaches.
resultsStudies on prone position are heterogeneous and most trials only refer to patients with large breasts; therefore, no definitive conclusion can be drawn for clinical routine. Nonetheless, there seems to be a trend toward better sparing of the left anterior descending artery in supine position even for these selected patients. The data on the use of DIBH for heart-sparing in breast cancer patients is consistent and the benefit compared to free-breathing is supported by several studies. In comparison with whole breast irradiation (WBI), PBI has an advantage in reducing the heart dose. Of note, DIBH and PBI with multicatheter brachytherapy are similar with regard to the dose reduction to heart structures. WBI by IMRT/VMAT techniques without DIBH is not an effective strategy for heart-sparing in breast cancer patients with "standard" anatomy. A combination of DIBH and IMRT may be used for internal mammary radiotherapy.
conclusionBased on the available findings, the DEGRO breast cancer expert panel recommends the use of DIBH as the best heart-sparing technique. Nonetheless, depending on the treatment volume and localization, other techniques may be employed or combined with DIBH when appropriate.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.