ArticleJACC. CardioOncology2024
Deep Inspiration Breath Hold in Left-Sided Breast Radiotherapy: A Balance Between Side Effects and Costs.
Article in JACC. CardioOncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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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
17 citing papers in PubMed.
- Combined re-radiation therapy and regional or capacitive hyperthermia as a part of multimodal treatment for locoregional breast cancer recurrences in previously irradiated areas.Radiation oncology (London, England) · 2026Article
- 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
- Cardiac substructure dosimetry in thoracic radiotherapy: moving beyond mean heart dose and toward precision cardiac risk mitigation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- Clinical Predictors of Dosimetric Precedence for Deep Inspiratory Breath Hold Radiation Therapy for Breast Cancer.Diagnostics (Basel, Switzerland) · 2026Article
- Dosimetric advantages and clinical feasibility of a novel lateral decubitus position for left breast cancer patients undergoing PORT.Radiation oncology (London, England) · 2026Article
- Redefining Gamification for Cardiovascular Prevention in High-Risk Cancer Survivors.JACC. CardioOncology · 2026Article
- Cost-Effectiveness of Proton Therapy Compared With Photon Therapy in Breast Cancer.JAMA network open · 2026Article
- Feasibility and workflow efficiency of automated deep inspiration breath-hold for locoregional breast irradiation on a ring-gantry accelerator.Physics and imaging in radiation oncology · 2026Article
- Deep inspiration breath-hold for breast cancer radiotherapy: a modelling study of targeted versus non-targeted strategy for clinical and operational optimisation.The Lancet regional health. Europe · 2026Article
- Ultra-hypofractionation versus standard hypofractionation in post-mastectomy radiotherapy (PMRT): a prospective randomised dosimetric and clinical comparison study.Ecancermedicalscience · 2026Article
- Epidemiology, early detection, and management of breast cancer in China: A comprehensive review.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2025Article
- Cancer therapy-induced cardiotoxicity: mechanisms and mitigations.Heart failure reviews · 2025Review
- Cardiac Effects of Modern Breast Radiation Therapy in Patients Receiving Systemic Cancer Therapy.JACC. CardioOncology · 2025Article
- Deep Inspiration Breath Hold to Reduce Cardiovascular Disease Risk for Breast Radiotherapy: Challenges and Opportunities.JACC. CardioOncology · 2024Article
- Reply: Deep Inspiration Breath Hold to Reduce Cardiovascular Disease Risk for Breast Radiotherapy: Challenges and Opportunities.JACC. CardioOncology · 2024Article
- Heart is a heavy burden: cardiac toxicity in radiation oncology.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Review
- Deep Inspiration Breath Hold for Cardiac Sparing: No Deep Pockets Required.JACC. CardioOncology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Deep inspiration breath hold (DIBH) is an effective technique for reducing heart exposure during radiotherapy for left-sided breast cancer. Despite its benefits, cost considerations and its impact on workflow remain significant barriers to widespread adoption. Objectives: This study aimed to assess the cost-effectiveness of DIBH and compare its operational, financial, and clinical outcomes with free breathing (FB) in breast cancer treatment. Methods: Treatment plans for 100 patients with left-sided breast cancer were generated using both DIBH and FB techniques. Dosimetric data, including the average mean heart dose, were calculated for each technique and used to estimate the cardiotoxicity of radiotherapy. A state-transition microsimulation model based on SCORE2 (Systematic Coronary Risk Evaluation) algorithms projected the effects of DIBH on cardiovascular outcomes and quality-adjusted life-years (QALYs). Costs were calculated from a provider perspective using time-driven activity-based costing, applying a willingness-to-pay threshold of €40,000 for cost-effectiveness assessment. A discrete event simulation model assessed the impacts of DIBH vs FB on throughput and waiting times in the radiotherapy workflow. Results: In the base case scenario, DIBH was associated with an absolute risk reduction of 1.72% (95% CI: 1.67%-1.76%) in total cardiovascular events and 0.69% (95% CI: 0.67%-0.72%) in fatal cardiovascular events over 20 years. Additionally, DIBH was estimated to provide an incremental 0.04 QALYs (95% CI: 0.05-0.05) per left-sided breast cancer patient over the same time period. However, DIBH increased treatment times, reducing maximum achievable throughput by 12.48% (95% CI: 12.36%-12.75%) and increasing costs by €617 per left-sided breast cancer patient (95% CI: €615-€619). The incremental cost-effectiveness ratio was €14,023 per QALY. Conclusions: Despite time investments, DIBH is cost-effective in the Belgian population. The growing adoption of DIBH may benefit long-term cardiovascular health in breast cancer survivors.
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