ArticleBreast cancer (Tokyo, Japan)2026
Two breasts, one breath: continuous positive airway pressure for innovative heart sparing in synchronous bilateral breast cancer radiotherapy.
Article in Breast cancer (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine the impact of continuous positive airway pressure (CPAP) breathing on organ at risk (OAR) sparing in synchronous bilateral breast cancer (SBBC) radiotherapy. MATERIALS AND
methodsPatients with SBBC planned for adjuvant bilateral irradiation were prospectively enrolled in this study. Patients first underwent a free breathing (FB) planning computed tomography (CT). They were trained to breath with CPAP device for 30 min under a maximum tolerable pressure of 10-15cmH
resultsA total of 40 SBBC patients were included in this study. All patient successfully completed the simulation procedure. CPAP breathing yielded significant lungs expansion (+ 46.5%), and subsequently displaced the heart inferiorly and medially. Heart volume within tangential fields was reduced by 72% with CPAP breathing (p = 0.00). Favourable physical changes induced by CPAP breathing resulted in significant reduction of all dose metrics to the heart, LV, LAD and lung. MHD was reduced by 32% (p = 0.005). Dose reduction to cardiac subvolumes reached - 66% and - 64% respectively for V35.3 Gy LAD and V20.3 Gy LV.
conclusionCPAP offered significant cardiac and lung dose reductions in SBBC radiotherapy. These findings support CPAP as an accessible and efficient heart-sparing technique, particularly in clinical settings where deep inspiration breath hold is unavailable or unfeasible.
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