Open    Access



Deep Inspiration Breath Hold Techniques with Homemade LPT System for Left Breast Cancer Comparison between 3DCRT and IMRT



Author(s)

Mokhlesur Rahman, Hafizur Rahman, Mahmudul Hasan, Hasin Anupama Azhari, Golam Abu Zakaria, Abdul Gafur, Taslim Reza, Atabul Islam, Imran Hossain and Whaheduzzaman

Full-Text PDF XML     528 Views

DOI:10.17265/2328-2150/2023.01.002

Background and Purpose: Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and lung. IMRT-DIBH becomes more suitable for treating complex target volumes as it is able to generate more complicated dose distributions and dose gradients with narrower margins than those allowed using traditional methods. As a consequence, IMRT can provide a dosimetric benefit in terms of increased tumor control through escalated dose and reduced normal tissue complications through OARs sparing compared to 3DCRT-DIBH. The purpose of this study is to present a comparison between the dosimetric aspects of 3DCRT-DIBH and IMRT-DIBH in the left-sided breast radiotherapy. Materials and Methods: CT studies of 10 patients with early stage left breast cancer who underwent breast conservative surgery were planned using 3DCRT-DIBH compared with DIBH-IMRT data-set that was the international article completed by Amy J Hayden: Journal of Medical Imaging and Radiation Oncology. PTV, lungs, heart and contralateral breast (CB) were outlined. The dose prescribed was 50 Gray in 25 fractions to the left breast PTV. Dose volume histogram parameters (DVPs) for both plans were compared and analyzed statistically using Wilcoxon Signed-Ranks test. Results: Both 3DCRT-DIBH and IMRT-DIBH achieved adequate and comparable target coverage. On the other hand, tangential IMRT-DIBH showed insignificant higher PTV maximum dose with significant less dose homogeneity compared to 3DCRT. This is with greater sparing of the heart and contralateral breast in IMRT-DIBH plans. 3DCRT-DIBH technique seems better in sparing critical organs parameters like lung V20 and Mean lung Dose. Conclusion: IMRT –DIBH for breast cancer treatment is feasible. In comparison to 3DCRT-DIBH, IMRT-DIBH can show incidentally the maximum dose to the target volume, and dose to the OAR. However, 3DCRT technique is superior in terms of low dose volume, integral dose, and treatment time. With the use of deep inspiration breath-hold technique in IMRT, it can further improve the target coverage and reduction of doses to the heart, heart V30, LAD and contralateral breast.

Breast cancer radiotherapy, Deep inspiration breath hold, Planning Tumor Volume, Cardiac toxicity, IMRT, 3DCRT, Organs at Risk and mastectomy.

Rahman, M., Rahman, H., Hasan, M., et al. 2023. "Deep Inspiration Breath Hold Techniques with Homemade LPT System for Left Breast Cancer Comparison between 3DCRT and IMRT." Journal of Pharmacy and Pharmacology 11 (1): 7-20.