SynthesisPloS one2026
Deep inspiration breath hold versus free breathing in postoperative radiotherapy strategy for patients with left-sided breast cancer treated with volumetric modulated arc therapy: A meta-analysis and systematic review.
Synthesis in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled 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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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
This meta-analysis aimed to determine the effect of deep inspiration breath hold (DIBH) compared with free breathing (FB) on dose to the organs at risk (OARs), such as the heart, left anterior descending (LAD) coronary artery, lungs, and contralateral breast, in patients with left-sided breast cancer treated with volumetric modulated arc therapy (VMAT). PubMed, EMBASE, and Cochrane Library electronic databases were searched for studies until March 21, 2024. Cochrane RevMan version 5.4 statistical software was used to analyze 11 eligible studies. Standard mean difference (SMD), with 95% confidence interval for OAR dose reductions, was calculated. DIBH considerably resulted in lower mean doses (Dmean) to the heart (SMD = -1.40 Gy), LAD (SMD = -1.65 Gy), ipsilateral lung (SMD = -0.57 Gy), contralateral lung (SMD = -0.46 Gy), and contralateral breast (SMD = -0.20 Gy). If VMAT was delivered with an arc of >180O, the heart Dmean reduction was even more pronounced. Subgroup analysis revealed that DIBH efficiently reduced heart Dmean, especially in patients with tumor bed boost without nodal irradiation. DIBH was effective in reducing dose to OARs in patients treated with VMAT in all subgroups, i.e., breast only, with/without tumor bed boost, and with/without nodal irradiation. Furthermore, the use of DIBH is strongly recommended for patients undergoing VMAT with a tumor bed boost or without nodal irradiation, as it is more effective in reducing heart Dmean than FB.
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Registered trials
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