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Reduction of Heart Dose using Voluntary Deep Inspiration Breath-Holding Technique in Left Breast Cancer Patients Treated by Hypo Fractionated Radiation Therapy

Aim: This study aims to compare between conventional free-breathing simulation technique and Deep-Inspiration Breath Holding (DIBH) technique regarding doses to the heart and ipsilateral lung.

Patients and Methods: Sixty-six patients with left-sided breast cancer who presented to the radiotherapy department at National Cancer Institute, Cairo, Egypt between November 2015 and December 2016 were accrued. Patients were planned by 3D conformal radiotherapy technique with a dose of 4005 cGy/15 fx to left breast/chest wall ± supraclavicular lymph nodes. All patients were simulated during free breathing and after voluntary Deep Inspiration Breath Holding.

Result: In this study, whether patients had undergone MRM or CBS, heart, and LAD artery doses, were highly statistically significance lower (p-value<0.001), and left lung doses were statistically significant lower (p-value<0.05) using DIBH technique than that of free-breathing (FB).

Conclusion: The Deep Inspiration Breath Hold (DIBH) technique can be associated with lower radiation exposure to the heart, Left Anterior Descending (LAD) Artery, and ipsilateral lung without compromising coverage of the breast or chest wall.


Samy Elbadawy, Hanaa Attia, Roa Eltagy and Mohamed Mahmoud

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