Ippolito, E.; Greco, C.; Marrocco, M.; Rinaldi, C.G.; Fiore, M.; Trodella, L.E.; D’Angelillo, R.M.; Ramella, S. Preventing Cardiotoxicity in Personalized Breast Irradiation. Cancers2023, 15, 5153.
Ippolito, E.; Greco, C.; Marrocco, M.; Rinaldi, C.G.; Fiore, M.; Trodella, L.E.; D’Angelillo, R.M.; Ramella, S. Preventing Cardiotoxicity in Personalized Breast Irradiation. Cancers 2023, 15, 5153.
Ippolito, E.; Greco, C.; Marrocco, M.; Rinaldi, C.G.; Fiore, M.; Trodella, L.E.; D’Angelillo, R.M.; Ramella, S. Preventing Cardiotoxicity in Personalized Breast Irradiation. Cancers2023, 15, 5153.
Ippolito, E.; Greco, C.; Marrocco, M.; Rinaldi, C.G.; Fiore, M.; Trodella, L.E.; D’Angelillo, R.M.; Ramella, S. Preventing Cardiotoxicity in Personalized Breast Irradiation. Cancers 2023, 15, 5153.
Abstract
Background: to assess the benefit of a deep inspiration breath hold (DIBH) over standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with LAD dose. Methods: We retrospectively identified patients with left-sided breast cancer who underwent whole breast radiotherapy in DIBH. All patients had both plans in DIBH and free-breathing (FB). Receiving operating characteristics (ROC analysis) were performed to define the cut-off point of parameters to predict LAD maximum dose >10 Gy and LAD mean dose > 4 Gy. Areas under the curve (AUCs) were calculated for all variables. Post-test probability has been calculated to evaluate advantage for parameters combination. Results: One hundred ninety-seven patients were identified. LAD dose was significantly reduced in DIBH plans with maximum and mean dose reduced by 31.7% (mean value 3.5 Gy vs 4.8 Gy, p=<0.001) and 28.1% (mean value 8.2 Gy vs 12.8 Gy, p=<0.001) in DIBH plans compared to FB plans. The strongest predictor of LAD maximum dose > 10 Gy and a LAD mean dose > 4 Gy was the minimum distance of LAD from tangent open fields. Other parameters were lung volume and heart volume for LAD Dmax > 10 Gy and lung volume, heart volume and breast separation for LAD Dmean > 4 Gy. Conclusion: The dosimetric benefit of DIBH is valid for all patients and DIBH should be preferred for all left sided patients.
Keywords
DIBH; breast cancer; left descending artery; breast irradiation
Subject
Medicine and Pharmacology, Oncology and Oncogenics
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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