Abstract：
BACKGROUND: The moderate deep inspiratory breath hold (mDIBH) is a modality famed for cardiac sparing. Prospective studies based on this are few from the eastern part of the world and India. We intend to compare the dosimetry between mDIBH and free-breathing (FB) plans.
METHODS: Thirty-two locally advanced left breast cancer patients were taken up for the study. All patients received a dose of 50 Gy in 25 fractions to the chest wall/intact breast, followed by a 10-Gy boost to the lumpectomy cavity in the case of breast conservation surgery. All the patients were treated in mDIBH using active breath coordinator (ABC). The data from the two dose volume histograms were compared regarding plan quality and the doses received by the organs at risk. Paired t-test was used for data analysis.
RESULTS: The dose received by the heart in terms of V5, V10, and V30 (4.55% vs 8.39%) and mean dose (4.73 Gy vs 6.74 Gy) were statistically significant in the ABC group than that in the FB group (all p-values < 0.001). Also, the dose received by the LADA in terms of V30 (19.32% vs 24.87%) and mean dose (32.99 Gy vs 46.65 Gy) were significantly less in the ABC group. The mean treatment time for the ABC group was 20 min, while that for the free-breathing group was 10 min.
CONCLUSIONS: Incorporating ABC-mDIBH for left-sided breast cancer radiotherapy significantly reduces the doses received by the heart, LADA, and left and right lung, with no compromise in plan quality but with an increase in treatment time.
METHODS: Thirty-two locally advanced left breast cancer patients were taken up for the study. All patients received a dose of 50 Gy in 25 fractions to the chest wall/intact breast, followed by a 10-Gy boost to the lumpectomy cavity in the case of breast conservation surgery. All the patients were treated in mDIBH using active breath coordinator (ABC). The data from the two dose volume histograms were compared regarding plan quality and the doses received by the organs at risk. Paired t-test was used for data analysis.
RESULTS: The dose received by the heart in terms of V5, V10, and V30 (4.55% vs 8.39%) and mean dose (4.73 Gy vs 6.74 Gy) were statistically significant in the ABC group than that in the FB group (all p-values < 0.001). Also, the dose received by the LADA in terms of V30 (19.32% vs 24.87%) and mean dose (32.99 Gy vs 46.65 Gy) were significantly less in the ABC group. The mean treatment time for the ABC group was 20 min, while that for the free-breathing group was 10 min.
CONCLUSIONS: Incorporating ABC-mDIBH for left-sided breast cancer radiotherapy significantly reduces the doses received by the heart, LADA, and left and right lung, with no compromise in plan quality but with an increase in treatment time.
摘要：
背景：中度深吸气屏气（mDIBH）是一种以心脏保留而闻名的方式。基于此的前瞻性研究很少来自世界东部和印度。我们打算比较mDIBH和自由呼吸（FB）计划之间的剂量学。
方法：研究对象为32例局部晚期左乳癌患者。所有患者接受50Gy的剂量，分为25个部分，以胸壁/完整的乳房，在乳房保护手术的情况下，随后对乳房切除术腔进行10Gy的提升。所有患者均使用主动呼吸协调器（ABC）进行mDIBH治疗。关于计划质量和由有风险的器官接收的剂量,比较来自两个剂量体积直方图的数据。采用配对t检验进行数据分析。
结果：ABC组的心脏接受V5，V10和V30的剂量（4.55％vs8.39％）和平均剂量（4.73Gyvs6.74Gy）均具有统计学意义。比FB组（所有p值<0.001）。此外，在ABC组中,LADA接受的V30剂量(19.32%vs24.87%)和平均剂量(32.99Gyvs46.65Gy)明显较少.ABC组的平均治疗时间为20分钟，而自由呼吸组为10分钟。
结论：将ABC-mDIBH纳入左侧乳腺癌放疗可显著降低心脏接受的剂量，LADA,左肺和右肺，计划质量没有妥协，但治疗时间增加。
方法：研究对象为32例局部晚期左乳癌患者。所有患者接受50Gy的剂量，分为25个部分，以胸壁/完整的乳房，在乳房保护手术的情况下，随后对乳房切除术腔进行10Gy的提升。所有患者均使用主动呼吸协调器（ABC）进行mDIBH治疗。关于计划质量和由有风险的器官接收的剂量,比较来自两个剂量体积直方图的数据。采用配对t检验进行数据分析。
结果：ABC组的心脏接受V5，V10和V30的剂量（4.55％vs8.39％）和平均剂量（4.73Gyvs6.74Gy）均具有统计学意义。比FB组（所有p值<0.001）。此外，在ABC组中,LADA接受的V30剂量(19.32%vs24.87%)和平均剂量(32.99Gyvs46.65Gy)明显较少.ABC组的平均治疗时间为20分钟，而自由呼吸组为10分钟。
结论：将ABC-mDIBH纳入左侧乳腺癌放疗可显著降低心脏接受的剂量，LADA,左肺和右肺，计划质量没有妥协，但治疗时间增加。
