Postoperative Irradiation of Left-Sided Breast Cancer Patients and Cardiac Toxicity

Abstract

This study demonstrates that irradiated cardiac volumes can significantly be reduced in left-sided breast cancer patients using DIBH technique for postoperative tangential radiotherapy. Moreover, the technique is safe and feasible in daily routine.

Ist die Kardiotoxizität der Radiotherapie im Rahmen des Brusterhalts überhaupt noch relevant, und könnte sie durch Mehrfelder-IMRT gesenkt werden?

“…Eine weitere Technik, die in manchen Situationen allein, in anderen Situationen zusammen mit der Mehrfelder-IMRT eingesetzt werden kann, ist die Bestrahlung in tiefer Einatmung, entweder als Gating-Verfahren oder manuell gesteuert [6,76,86]. Die Wirksamkeit dieser Methode ist auf Patienten beschränkt, die zu kontrollierten Atemmanövern in der Lage sind (laut Literatur ca.…”

Quantitative Assessment of Irradiated Lung Volume and Lung Mass in Breast Cancer Patients Treated with Tangential Fields in Combination with Deep Inspiration Breath Hold (DIBH)

“…A reduction of absolute volume and dose may translate into a reduction of late effects of radiation and radiation in combination with neoadjuvant, concomitant, or adjuvant cardiotoxic systemic agents (e.g., chemotherapy, biologicals) [11,27,28].…”

Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer

“…More importantly, there is no apparent threshold below which there is no risk, making every further effort to reduce the dose applied to the heart relevant [6]. Performing the radiotherapy treatment to the left breast in deep inspiration breath-hold (DIBH) technique reduces the dose applied to the heart [9][10][11][12][13], but despite convincing published evidence, this technique has not found its way into routine practice. DIBH requires the patient to breathe in deeply and hold breath in a standardised technique during CT simulation.…”