ArticleESMO open2024
Surface-based deep inspiration breath-hold radiotherapy in left-sided breast cancer: final results from the SAVE-HEART study.
Article in ESMO open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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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
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Trial
- 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
- Article
- Feasibility of predicting free-breathing body contours from biplanar CT scout images for surface-guided DIBH radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Optimizing Cardiac Dose Prediction in Left-Sided Breast Cancer Radiation Therapy: Clinical Strategies for Identifying Beneficiaries of the Deep Inspiration Breath-Hold Technique.Advances in radiation oncology · 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
- Upright versus supine positioning for breast and lung radiotherapy: a pilot study on patient comfort, experience and lung function.Technical innovations & patient support in radiation oncology · 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
- 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
- Clinical factors affecting breath-hold performance for left-sided breast cancer patients.Journal of applied clinical medical physics · 2025Article
- Assessment of the Effectiveness of a Visual Coaching Device Combined with Auditory Instructions on Reproducibility and Stability in Deep Inspiration Breath-Hold Radiotherapy.Journal of clinical medicine · 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
- Optimizing Breast Cancer Radiation therapy With Volumetric Modulated Arc Therapy and Skin Flash: A Case Study Using Deep Inspiration Breath Hold and Cherenkov Imaging.Advances in radiation oncology · 2025Article
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdjuvant radiotherapy (RT) plays an essential role in the management of early breast cancer (BC), but can lead to cardiovascular and lung toxicities. RT in deep inspiration breath hold (DIBH) often allows better protection of organs at risk. This prospective study compares surface-guided DIBH with free breathing (FB) in patients with left-sided BC, by evaluating individual cardiovascular risks and treatment plan dosimetry. PATIENTS AND
methodsThe study enrolled 585 patients from October 2016 to January 2021 with left-sided invasive breast carcinoma with indicated adjuvant RT of the breast/thoracic wall with or without regional lymph nodes. The ability to hold breath for 20 s was a prerequisite. The treatments were either hypofractionated (HF; 40.05 Gy/15Fx) or normofractionated (NF; 50.00 Gy/25Fx). DIBH was applied using the automatically triggered surface guidance system Catalyst with audio-video feedback. Computed tomography and surface data were acquired during both DIBH and FB. The primary endpoint of the study was the comparative evaluation of heart dose reduction using DIBH.
resultsPlan dosimetry was significantly improved by DIBH. The mean and maximum doses to the heart and the left coronary artery were significantly reduced by 36%-42% in HF and NF plans (P < 0.001), while the mean ipsilateral lung dose was reduced by 12%-14% (P < 0.001). Furthermore, DIBH resulted in a 5% reduction in the cumulative 10-year cardiovascular disease risk (10-year cardiovascular disease risk) compared with FB (3.59% to 3.41%; P < 0.001).
conclusionTo the best of our knowledge, this is the largest prospective study showing better sparing for cardiac and ipsilateral lung doses with surface-guided DIBH compared with FB in patients with left-sided BC.
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