Junming Lai1, Shuang Hu2, Yongbiao Luo3, Rikui Zheng3, Qibao Zhu3, Pingliang Chen3, Beiyuan Chi3, Yunhui Zhang4, Fangyan Zhong5, Xin Long6. 1. Department of Radiation Oncology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, 322000, Zhejiang, People's Republic of China. haixin27691@foxmail.com. 2. Department of General Medicine, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, 322000, Zhejiang, People's Republic of China. 3. Department of Radiation Oncology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, 322000, Zhejiang, People's Republic of China. 4. Department of Pediatrics, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, 322000, Zhejiang, People's Republic of China. 5. Department of Medicine of the Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China. 6. Department of Medicine of the Graduate School, Wuhan University, Wuhan, 430000, Hubei, People's Republic of China.
Abstract
OBJECTIVES: This meta-analysis evaluates the difference in deep inspiration breath hold (DIBH) versus free breathing (FB) for patients receiving postoperative radiotherapy for left breast cancer and provides a useful reference for clinical practice. METHODS: The relevant controlled trials of DIBH versus FB in postoperative radiotherapy for left-side breast cancer were retrieved from the databases of PubMed, Science Direct, Cochrane Library, and Web of Science databases. The principal outcome of interest was heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose and target coverage. We calculated summary standardized mean difference (SMD) and 95% confidence intervals (CI). The meta-analysis was performed using RevMan 5.3 software. RESULTS: The analysis included 1019 patients from 12 observational studies, of which 576 cases were in the DIBH group and 443 cases in the FB group. Compared with the FB group, the DIBH group can have lower heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose more effectively, and the difference was statistically significant (heart dose, SMD = - 1.36, 95% CI - 1.64 ~ - 1.09, P < 0.01. LADCA dose, SMD = - 1.45, 95% CI - 1.62 ~ - 1.27, P < 0.01. Left lung dose, SMD = - 0.52, 95% CI - 0.81 ~ - 0.23, P < 0.01). There was no significant difference in target coverage between the two groups (SMD = 0.03, 95% CI - 0.11 ~ 0.18, P = 0.64). CONCLUSION: By this meta-analysis, we found that implementation of DIBH in postoperative radiotherapy for left-side breast cancer can reduce irradiation of heart dose, LADCA dose and left lung dose, without compromising target coverage.
OBJECTIVES: This meta-analysis evaluates the difference in deep inspiration breath hold (DIBH) versus free breathing (FB) for patients receiving postoperative radiotherapy for left breast cancer and provides a useful reference for clinical practice. METHODS: The relevant controlled trials of DIBH versus FB in postoperative radiotherapy for left-side breast cancer were retrieved from the databases of PubMed, Science Direct, Cochrane Library, and Web of Science databases. The principal outcome of interest was heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose and target coverage. We calculated summary standardized mean difference (SMD) and 95% confidence intervals (CI). The meta-analysis was performed using RevMan 5.3 software. RESULTS: The analysis included 1019 patients from 12 observational studies, of which 576 cases were in the DIBH group and 443 cases in the FB group. Compared with the FB group, the DIBH group can have lower heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose more effectively, and the difference was statistically significant (heart dose, SMD = - 1.36, 95% CI - 1.64 ~ - 1.09, P < 0.01. LADCA dose, SMD = - 1.45, 95% CI - 1.62 ~ - 1.27, P < 0.01. Left lung dose, SMD = - 0.52, 95% CI - 0.81 ~ - 0.23, P < 0.01). There was no significant difference in target coverage between the two groups (SMD = 0.03, 95% CI - 0.11 ~ 0.18, P = 0.64). CONCLUSION: By this meta-analysis, we found that implementation of DIBH in postoperative radiotherapy for left-side breast cancer can reduce irradiation of heart dose, LADCA dose and left lung dose, without compromising target coverage.
Entities:
Keywords:
Breast cancer; Deep inspiration breath hold; Meta-analysis; Radiotherapy
Authors: Zsuzsanna Kahán; Tamás Csont; Márta Sárközy; Zoltán Varga; Renáta Gáspár; Gergő Szűcs; Mónika G Kovács; Zsuzsanna Z A Kovács; László Dux Journal: Clin Res Cardiol Date: 2021-02-16 Impact factor: 5.460