Evidence map›Paper›PMID 38550309›Full record

ArticleClinical and translational radiation oncology2024

Individual benefit in heart sparing during DIBH-supported left breast radiotherapy.

Szilvia Gaál, Zsuzsanna Kahán, Ferenc Rárosi, Gergely H Fodor, József Tolnai, Bence Deák, Katalin Hideghéty, Zoltán Varga

Abstract read
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Article in Clinical and translational radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Szilvia GaálDepartment of Oncotherapy, University of Szeged, Szeged, Hungary.
Zsuzsanna KahánDepartment of Oncotherapy, University of Szeged, Szeged, Hungary.
Ferenc RárosiDepartment of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
Gergely H FodorDepartment of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
József TolnaiDepartment of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
Bence DeákDepartment of Oncotherapy, University of Szeged, Szeged, Hungary.
Katalin HideghétyDepartment of Oncotherapy, University of Szeged, Szeged, Hungary.
Zoltán VargaDepartment of Oncotherapy, University of Szeged, Szeged, Hungary.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Deep-inspirational breath hold (DIBH) is an option for heart protection in breast radiotherapy; we intended to study its individual benefit. Materials and Methods: 3DCRT treatment planning was performed in a cohort of 103 patients receiving radiotherapy of the whole breast (WBI)/chest wall (CWI) ± nodal regions (NI) both under DIBH and free breathing (FB) in the supine position, and in the WBI only cases prone (n = 45) position, too. A series of patient-related and heart dosimetry parameters were analyzed. Results: The DIBH technique provided dramatic reduction of all heart dosimetry parameters the individual benefit, however, varied. In the whole population the best predictor of benefit was the ratio of ipsilateral lung volume (ILV)FB and ILVDIBH. In the WBI cohort 9-11 patients and 5-8 patients received less dose to selected heart structures with the DIBH and prone positioning, respectively; based on meeting various dose constraints DIBH was the only solution in 6-13 cases, and prone positioning in 5-6 cases. In addition to other excellent predictors, a small ILVFB or ILVDIBH with outstanding predicting performance (AUC ≥ 0.90) suggested prone positioning. Detailed analysis consistently indicated the outstanding performance of ILVFB and ILVDIBH in predicting the benefit of one over the other technique in lowering the mean heart dose (MHD), left anterior descending coronary artery (LAD) mean dose and left ventricle(LV)-V5Gy. The preference of prone positioning was further confirmed by anatomical parameters measured on a single CT scan at the middle of the heart. Performing spirometry in a cohort of 12 patients, vital capacity showed the strongest correlation with ILVFB and ILVDIBH hence this test could be evaluated as a clinical tool for patient selection. Discussion: Individual lung volume measures estimated by spirometry and anatomical data examined prior to acquiring planning CT may support the preference of DIBH or prone radiotherapy for optimal heart protection.

Indexed as

Breast radiotherapyDIBHPredictorsRadiation heart damageSpirometry

Identifiers

PMID38550309
PMCPMC10972839

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