F R Bartlett1, E M Donovan2, H A McNair3, L A Corsini3, R M Colgan2, P M Evans4, L Maynard5, C Griffin5, J S Haviland6, J R Yarnold7, A M Kirby8. 1. Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK; Department of Oncology and Haematology, Queen Alexandra Hospital, Portsmouth, UK. 2. Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK. 3. Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK. 4. Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK; Centre for Vision, Speech and Signal Processing, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, UK. 5. Clinical Trials and Statistics Unit (ICR-CTSU), Institute of Cancer Research, London, UK. 6. Faculty of Health Sciences, University of Southampton, Southampton, UK. 7. Division of Radiotherapy and Imaging, Institute of Cancer Research, Sutton, UK. 8. Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK. Electronic address: anna.kirby@rmh.nhs.uk.
Abstract
AIMS: To evaluate the feasibility and heart-sparing ability of the voluntary breath-hold (VBH) technique in a multicentre setting. MATERIALS AND METHODS: Patients were recruited from 10 UK centres. Following surgery for early left breast cancer, patients with any heart inside the 50% isodose from a standard free-breathing tangential field treatment plan underwent a second planning computed tomography (CT) scan using the VBH technique. A separate treatment plan was prepared on the VBH CT scan and used for treatment. The mean heart, left anterior descending coronary artery (LAD) and lung doses were calculated. Daily electronic portal imaging (EPI) was carried out and scanning/treatment times were recorded. The primary end point was the percentage of patients achieving a reduction in mean heart dose with VBH. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. RESULTS: In total, 101 patients were recruited during 2014. Primary end point data were available for 93 patients, 88 (95%) of whom achieved a reduction in mean heart dose with VBH. Mean cardiac doses (Gy) for free-breathing and VBH techniques, respectively, were: heart 1.8 and 1.1, LAD 12.1 and 5.4, maximum LAD 35.4 and 24.1 (all P<0.001). Population EPI-based displacement data showed Σ =+1.3-1.9 mm and σ=1.4-1.8 mm. Median CT and treatment session times were 21 and 22 min, respectively. CONCLUSIONS: The VBH technique is confirmed as effective in sparing heart tissue and is feasible in a multicentre setting.
AIMS: To evaluate the feasibility and heart-sparing ability of the voluntary breath-hold (VBH) technique in a multicentre setting. MATERIALS AND METHODS:Patients were recruited from 10 UK centres. Following surgery for early left breast cancer, patients with any heart inside the 50% isodose from a standard free-breathing tangential field treatment plan underwent a second planning computed tomography (CT) scan using the VBH technique. A separate treatment plan was prepared on the VBH CT scan and used for treatment. The mean heart, left anterior descending coronary artery (LAD) and lung doses were calculated. Daily electronic portal imaging (EPI) was carried out and scanning/treatment times were recorded. The primary end point was the percentage of patients achieving a reduction in mean heart dose with VBH. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. RESULTS: In total, 101 patients were recruited during 2014. Primary end point data were available for 93 patients, 88 (95%) of whom achieved a reduction in mean heart dose with VBH. Mean cardiac doses (Gy) for free-breathing and VBH techniques, respectively, were: heart 1.8 and 1.1, LAD 12.1 and 5.4, maximum LAD 35.4 and 24.1 (all P<0.001). Population EPI-based displacement data showed Σ =+1.3-1.9 mm and σ=1.4-1.8 mm. Median CT and treatment session times were 21 and 22 min, respectively. CONCLUSIONS: The VBH technique is confirmed as effective in sparing heart tissue and is feasible in a multicentre setting.
Authors: Pieter Deseyne; Bruno Speleers; Wilfried De Neve; Bert Boute; Leen Paelinck; Tom Van Hoof; Joris Van de Velde; Annick Van Greveling; Chris Monten; Giselle Post; Herman Depypere; Liv Veldeman Journal: Radiat Oncol Date: 2017-05-26 Impact factor: 3.481
Authors: Adrian Murray Brunt; Joanne S Haviland; Duncan A Wheatley; Mark A Sydenham; Abdulla Alhasso; David J Bloomfield; Charlie Chan; Mark Churn; Susan Cleator; Charlotte E Coles; Andrew Goodman; Adrian Harnett; Penelope Hopwood; Anna M Kirby; Cliona C Kirwan; Carolyn Morris; Zohal Nabi; Elinor Sawyer; Navita Somaiah; Liba Stones; Isabel Syndikus; Judith M Bliss; John R Yarnold Journal: Lancet Date: 2020-04-28 Impact factor: 202.731