ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2023
Deep inspiration breath-hold radiation therapy in left-sided breast cancer patients: a single-institution retrospective dosimetric analysis of organs at risk doses.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Surface-guided deep-inspiration breath-hold radiotherapy for left-sided breast cancer: a systematic review and meta-analysis of dosimetric outcomes and image-verified setup accuracy.Frontiers in oncology · 2026Pooled it
- Surface-guided radiation therapy combined with real-time position management-guided deep inspiratory breath-hold radiotherapy for left breast cancer.BMC cancer · 2026Trial
- Trial
- 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
- Acute adverse events of ultra-hypofractionated whole-breast irradiation after breast-conserving surgery for early breast cancer in Japan: an interim analysis of the multi-institutional phase II UPBEAT study.Breast cancer (Tokyo, Japan) · 2024Trial
- Comparative dosimetric analysis of deep inspiration breath-hold versus free breathing radiotherapy in lung cancer: special emphasis on cardiac and subcardiac structure protection.Technical innovations & patient support in radiation oncology · 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
- Cardiac Substructure Dose Reduction and Toxicity Risk Assessment: IMPT Versus IMRT for Breast Cancer.International journal of particle therapy · 2025Article
- De-escalation strategies in early breast cancer: implications of sentinel lymph node biopsy omission for adjuvant radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- A deep learning model to predict dose distributions for breast cancer radiotherapy.Discover oncology · 2025Article
- Strategies to Reduce Left Anterior Descending Artery and Left Ventricle Organ Doses in Radiotherapy Planning for Left-Sided Breast Cancer.Reviews in cardiovascular medicine · 2025Article
- Multidisciplinary strategies to reduce radiotherapy-induced cardiotoxicity in breast cancer: surgical and technological innovations.Frontiers in oncology · 2025Review
- Surface-based deep inspiration breath-hold radiotherapy in left-sided breast cancer: final results from the SAVE-HEART study.ESMO open · 2024Article
- Impact of deep inspiration breath hold, surface-guided radiotherapy, and daily CBCT on the organs at risk in breast cancer radiotherapy.Scientific reports · 2024Article
- Prospective Randomized Trial Comparing 2 Devices for Deep Inspiration Breath Hold Management in Breast Radiation Therapy: Results of the BRAVEHeart Trial.Advances in radiation oncology · 2024Article
- Dosimetric advantages for cardiac substructures in radiotherapy of esophageal cancer in deep-inspiration breath hold.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Dosimetric analysis of half-field-based VMAT with the deep inspiration breath-hold technique for left breast cancer patients following breast-conserving surgery.Frontiers in oncology · 2024Article
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRadiotherapy can induce cardiac injury in left-sided breast cancer cases. Cardiac-sparing irradiation using the deep inspiration breath-hold (DIBH) technique can achieve substantial dose reduction to vulnerable cardiac substructures compared with free breathing (FB). This study evaluated the dosimetric differences between both techniques at a single institution.
methodsFrom 2017 to 2019, 130 patients with left-sided breast cancer underwent breast-conserving surgery (BCS; n = 121, 93.1%) or mastectomy (ME; n = 9, 6.9%) along with axillary lymph node staging (n = 105, 80.8%), followed by adjuvant irradiation in DIBH technique; adjuvant systemic therapy was included if applicable. 106 (81.5%) patients received conventional and 24 (18.5%) hypofractionated irradiation. Additionally, 12 patients received regional nodal irradiation. Computed tomography (CT) scans in FB and DIBH position were performed for all patients. Intrafractional 3D position monitoring of the patient surface in deep inspiration and breath gating was performed using Sentinel and Catalyst HD 3D surface scanning systems (C-RAD, Catalyst, C‑RAD AB, Uppsala, Sweden). Individual coaching and determination of breathing amplitude during the radiation planning CT was performed. Three-dimensional treatment planning was performed using standard tangential treatment portals (6 or 18 MV). The delineation of cardiac structures and both lungs was done in both the FB and the DIBH scan.
resultsAll dosimetric parameters for cardiac structures were significantly reduced (p < 0.01 for all). The mean heart dose (Dmean) in the DIBH group was 1.3 Gy (range 0.5-3.6) vs. 2.2 Gy (range 0.9-8.8) in the FB group (p < 0.001). The Dmean for the left ventricle (LV) in DIBH was 1.5 Gy (range 0.6-4.5), as compared to 2.8 Gy (1.1-9.5) with FB (p < 0.001). The parameters for LV (V10 Gy, V15 Gy, V20 Gy, V23 Gy, V25 Gy, V30 Gy) were reduced by about 100% (p < 0.001). The LAD Dmean in the DIBH group was 4.1 Gy (range 1.2-33.3) and 14.3 Gy (range 2.4-37.5) in the FB group (p < 0.001). The median values for LAD such as V15 Gy, V20 Gy, V25 Gy, V30 Gy, and V40 Gy decreased by roughly 100% (p < 0.001). An increasing volume of left lung in the DIBH position resulted in dose sparing of cardiac structures.
conclusionFor all ascertained dosimetric parameters, a significant dose reduction could be achieved in DIBH technique.
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