Evidence map›Paper›PMID 38550657›Full record

ArticleTechnical innovations & patient support in radiation oncology2024

Deep inspiratory breath-hold radiotherapy on a Helical Tomotherapy unit: Workflow and early outcomes in patients with left-sided breast cancer.

Sapna Nangia, Nagarjuna Burela, Mayur Sawant, G Aishwarya, Patrick Joshua, Vijay Thiyagarajan, Utpal Gaikwad, Dayananda S Sharma

Open access · goldAbstract read
In one paragraph

Article in Technical innovations & patient support in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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 at 1 institution in 1 country.

Sapna NangiaDept of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Nagarjuna BurelaDept of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Mayur SawantClinical Physics, Accuray Medical Equipment Pvt Ltd, India.
G AishwaryaDept of Medical Physics, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Patrick JoshuaDept of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Vijay ThiyagarajanDept of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Utpal GaikwadDept of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Dayananda S SharmaDept of Medical Physics, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India.
Apollo Proton Cancer Centre · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The clinical implementation of deep inspiratory breath-hold (DIBH) radiotherapy to reduce cardiac exposure in patients with left-sided breast cancer is challenging with helical tomotherapy(HT) and has received little attention. We describe our novel approach to DIBH irradiation in HT using a specially designed frame and manual gating, and compare cardiac substructure doses with the free-breathing (FB) technique. Material and methods: The workflow incorporates staggered junctions and a frame that provides tactile feedback to the patient and monitoring for manual cut-off. The treatment parameters and clinical outcome of 20 patients with left-sided breast cancer who have undergone DIBH radiotherapy as a part of an ongoing prospective registry are reported. All patients underwent CT scans in Free Breathing (FB) and DIBH using the in-house Respiframe, which incorporates a tactile feedback-based system with an indicator pencil. Plans compared target coverage, cardiac doses, synchronizing treatment with breath-hold and avoiding junction repetition. MVCT scans are used for patient alignment. Results: The mean dose (Dmean) to the heart was reduced by an average of 34 % in DIBH-HT compared to FB-HT plans (3.8 Gy vs 5.7 Gy). Similarly, 32 % and 67.8 % dose reduction were noted in the maximum dose (D0.02 cc) of the left anterior descending artery, mean 12.3 Gy vs 18.1 Gy, and mean left ventricle V5Gy 13.2 % vs 41.1 %, respectively. The mean treatment duration was 451.5 sec with a median 8 breath-holds; 3 % junction locations between successive breath-holds were replicated. No locoregional or distant recurrences were observed in the 9-month median follow-up. Conclusion: Our workflow for DIBH with Helical-Tomotherapy addresses patient safety, treatment precision and challenges specific to this treatment unit. The workflow prevents junction issues by varying daily breath-hold durations and avoiding junction locations, providing a practical solution for left-sided breast cancer treatment with HT.

Indexed as

Breast cancerDIBHFrame-based tactile feedbackHelical TomotherapyManual gatingStaggered junctions

Identifiers

PMID38550657
PMCPMC10973135
OpenAlexW4393137063

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.