PURPOSE: To evaluate the feasibility, cardiac dose reduction, and the influence of the setup error on the delivered dose for fluoroscopy-guided deep inspiration breath hold (DIBH) irradiation using a cone-beam CT for irradiation of left-sided breast cancer patients. METHODS AND MATERIALS: Nineteen patients treated according to the DIBH protocol were evaluated regarding dose to the ipsilateral breast (or thoracic wall), heart, (left ventricle [LV] and left anterior descending artery [LAD]), and lung. The DIBH treatment plan was compared to the free-breathing (FB) treatment planning and to the dose data in which setup error was taken into account (i.e., actual delivered dose). RESULTS: The largest setup variability was observed in the direction perpendicular to the RT field (μ = -0.8 mm, Σ = 2.9 mm, σ = 2.0 mm). The mean (D(mean)) and maximum (D(max)) doses of the DIBH treatment plan was significantly lower compared with the FB treatment plan for the heart (34% and 25%, p < 0.001), LV (71% and 28%, p < 0.001), and LAD (52% and 39.8%, p < 0.001). For some patients, large differences were observed between the heart D(max) according to the DIBH treatment plan and the actual delivered dose (up to 71%), although D(max) was always smaller than the planned FB dose (mean group reduction = 29%, p < 0.001). CONCLUSION: The image-guided DIBH treatment protocol is a feasible irradiation method with small setup variability that significantly reduces the dose to the heart, LV, and LAD.
PURPOSE: To evaluate the feasibility, cardiac dose reduction, and the influence of the setup error on the delivered dose for fluoroscopy-guided deep inspiration breath hold (DIBH) irradiation using a cone-beam CT for irradiation of left-sided breast cancerpatients. METHODS AND MATERIALS: Nineteen patients treated according to the DIBH protocol were evaluated regarding dose to the ipsilateral breast (or thoracic wall), heart, (left ventricle [LV] and left anterior descending artery [LAD]), and lung. The DIBH treatment plan was compared to the free-breathing (FB) treatment planning and to the dose data in which setup error was taken into account (i.e., actual delivered dose). RESULTS: The largest setup variability was observed in the direction perpendicular to the RT field (μ = -0.8 mm, Σ = 2.9 mm, σ = 2.0 mm). The mean (D(mean)) and maximum (D(max)) doses of the DIBH treatment plan was significantly lower compared with the FB treatment plan for the heart (34% and 25%, p < 0.001), LV (71% and 28%, p < 0.001), and LAD (52% and 39.8%, p < 0.001). For some patients, large differences were observed between the heart D(max) according to the DIBH treatment plan and the actual delivered dose (up to 71%), although D(max) was always smaller than the planned FB dose (mean group reduction = 29%, p < 0.001). CONCLUSION: The image-guided DIBH treatment protocol is a feasible irradiation method with small setup variability that significantly reduces the dose to the heart, LV, and LAD.
Authors: Marko Laaksomaa; Mika Kapanen; Tanja Skyttä; Seppo Peltola; Simo Hyödynmaa; Pirkko-Liisa Kellokumpu-Lehtinen Journal: Rep Pract Oncol Radiother Date: 2014-07-15
Authors: Christopher Jensen; Jaime Urribarri; Daniel Cail; Joerg Rottmann; Pankaj Mishra; Tatiana Lingos; Thomas Niedermayr; Ross Berbeco Journal: Med Phys Date: 2014-02 Impact factor: 4.071
Authors: M E Mast; M W Heijenbrok; M L van Kempen-Harteveld; A L Petoukhova; A N Scholten; R Wolterbeek; J H M Schreur; H Struikmans Journal: Strahlenther Onkol Date: 2016-08-17 Impact factor: 3.621
Authors: Thomas Mulliez; Liv Veldeman; Tom Vercauteren; Werner De Gersem; Bruno Speleers; Annick Van Greveling; Dieter Berwouts; Vincent Remouchamps; Rudy Van den Broecke; Wilfried De Neve Journal: Radiat Oncol Date: 2015-01-09 Impact factor: 3.481
Authors: Marko Laaksomaa; Mika Kapanen; Mikko Haltamo; Tanja Skyttä; Seppo Peltola; Simo Hyödynmaa; Pirkko-Liisa Kellokumpu-Lehtinen Journal: Radiat Oncol Date: 2015-04-03 Impact factor: 3.481