Open AccessImpact of different breathing conditions on the dose to surrounding normal structures in tangential field breast radiotherapy
Author(s) -
R Prabhakar,
T Ganesh,
Pramod Kumar Julka,
Goura Kishor Rath,
Rajesh Joshi,
Anil Kumar Bansal,
Raj Kishor Bisht,
Gopishankar Natanasabapathi,
G S Pant,
Sanjay Thulkar
Publication year - 2007
Publication title -
journal of medical physics/journal of medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.292
H-Index - 24
eISSN - 1998-3913
pISSN - 0971-6203
DOI - 10.4103/0971-6203.31146
Subject(s) - medicine , breast cancer , radiation therapy , breathing , expiration , nuclear medicine , lung cancer , left breast , lung , lung volumes , radiology , cancer , respiratory system , anesthesia
Cardiac toxicity is an important concern in tangential field breast radiotherapy. In this study, the impact of three different breathing conditions on the dose to surrounding normal structures such as heart, ipsilateral lung, liver and contralateral breast has been assessed. Thirteen patients with early breast cancer who underwent conservative surgery (nine left-sided and four right-sided breast cancer patients) were selected in this study. Spiral CT scans were performed for all the three breathing conditions, viz., deep inspiration breath-hold (DIBH), normal breathing phase (NB) and deep expiration breath-hold (DEBH). Conventional tangential fields were placed on the 3D-CT dataset, and the parameters such as V30 (volume covered by dose >30 Gy) for heart, V20 (volume covered by dose >20 Gy) for ipsilateral lung and V(50) (volume receiving >50% of the prescription dose) for heart and liver were studied. The average reduction in cardiac dose due to DIBH was 64% (range: 26.5-100%) and 74% (range: 37-100%) as compared to NB and DEBH respectively. For right breast cancer, DIBH resulted in excellent liver sparing. Our results indicate that in patients with breast cancer, delivering radiation in deep inspiration breath-hold condition can considerably reduce the dose to the surrounding normal structures, particularly heart and liver.