TY - JOUR
T1 - Heart Sparing Radiotherapy Techniques in Breast Cancer
T2 - A Focus on Deep Inspiration Breath Hold
AU - Stowe, Hayley B.
AU - Andruska, Neal D.
AU - Reynoso, Francisco
AU - Thomas, Maria
AU - Bergom, Carmen
N1 - Publisher Copyright:
© 2022 Stowe et al.
PY - 2022
Y1 - 2022
N2 - Adjuvant radiation therapy is a critical component of breast cancer management. However, when breast cancer patients receive incidental radiation to the heart, there is an increased risk of cardiac disease and mortality. This is most common for patients with left-sided breast cancers and those receiving nodal irradiation as part of treatment. The overall risk of cardiac toxicity increases 4– 16% with each Gray increase in mean heart radiation dose, with data suggesting that no lower limit exists which would eliminate cardiac risk entirely. Radiation techniques have improved over time, leading to lower cardiac radiation exposure than in the past. This decline is expected to reduce the incidence of radiation-induced heart dysfunction in patients. Deep inspiration breath hold (DIBH) is one such technique that was developed to reduce the risk of cardiac death and coronary events. DIBH is a non-invasive approach that capitalizes on the natural physiology of the respiratory cycle to increase the distance between the heart and the therapeutic target throughout the course of radiation therapy. DIBH has been shown to decrease the mean incidental radiation doses to the heart and left anterior descending coronary artery by approximately 20–70%. In this review, we summarize different techniques for DIBH and discuss recent data on this technique.
AB - Adjuvant radiation therapy is a critical component of breast cancer management. However, when breast cancer patients receive incidental radiation to the heart, there is an increased risk of cardiac disease and mortality. This is most common for patients with left-sided breast cancers and those receiving nodal irradiation as part of treatment. The overall risk of cardiac toxicity increases 4– 16% with each Gray increase in mean heart radiation dose, with data suggesting that no lower limit exists which would eliminate cardiac risk entirely. Radiation techniques have improved over time, leading to lower cardiac radiation exposure than in the past. This decline is expected to reduce the incidence of radiation-induced heart dysfunction in patients. Deep inspiration breath hold (DIBH) is one such technique that was developed to reduce the risk of cardiac death and coronary events. DIBH is a non-invasive approach that capitalizes on the natural physiology of the respiratory cycle to increase the distance between the heart and the therapeutic target throughout the course of radiation therapy. DIBH has been shown to decrease the mean incidental radiation doses to the heart and left anterior descending coronary artery by approximately 20–70%. In this review, we summarize different techniques for DIBH and discuss recent data on this technique.
KW - active breathing control
KW - breast cancer
KW - deep inspiration breath hold
KW - heart
KW - radiation
KW - real-time position management
UR - http://www.scopus.com/inward/record.url?scp=85134505466&partnerID=8YFLogxK
U2 - 10.2147/BCTT.S282799
DO - 10.2147/BCTT.S282799
M3 - Review article
C2 - 35899145
AN - SCOPUS:85134505466
SN - 1179-1314
VL - 14
SP - 175
EP - 186
JO - Breast Cancer: Targets and Therapy
JF - Breast Cancer: Targets and Therapy
ER -