Effect of DIBH Coaching on Dosimetric Parameters of Heart and Lung Doses in Patients Undergoing Adjuvant Breast Radiotherapy.

Q2 Medicine

Asian Pacific Journal of Cancer Prevention Pub Date : 2025-05-01 DOI:10.31557/APJCP.2025.26.5.1809

Laraib Khan, Maham Khan, Fabiha Shakeel, Tooba Ali, Mariam Hina, Aahan Arif, Firza Rahim Sarfaraz, Maria Tariq, Asim Hafiz, Bilal Mazhar Qureshi, Ahmed Nadeem Abbasi, Nasir Ali

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引用次数: 0

Abstract

Introduction: Radiation exposure to the heart in women with left-sided breast cancer can lead to cardiac disease and increased mortality. Several techniques, including deep inspiration breath hold (DIBH), have been used to reduce cardiac exposure during radiotherapy. DIBH coaching prior to radiation planning can further reduce cardiac doses. This study aims to compare heart and lung dosimetric parameters between coached and non-coached patients using the DIBH technique for left-sided breast cancer treatment.

Methods: All patients with left-sided breast cancer who received adjuvant radiotherapy (RT) using the DIBH were included. The first cohort, designated as the non-coached group, received verbal guidance on the breath hold technique but did not undergo formal coaching. The second cohort involved a comprehensive coaching protocol, which began in January 2022. This protocol, led by a physician, included demonstrations and instructions for performing the DIBH technique in the clinic and encouraged patients to practice at home before and during RT to optimize cardiac protection.

Results: A total of 40 patients met the inclusion criteria for the study, with a mean age of 45.7 ± 8.38 years. Most patients had IDC and Stage II disease, and radiation was primarily delivered using 3DCRT with 4256 cGy in 16 fractions regimes. In terms of cardiac dose exposure, coached patients had slightly lower mean and maximum point cardiac doses, but these differences were not statistically significant. Coached patients also had a significantly lower mean V17 for left lung volume exposure compared to non-coached patients (18.3 vs. 21.6, p < 0.05).

Conclusion: DIBH coaching and home practice prior to RT planning can further reduce cardiac and lung doses, offering a cost-effective intervention, particularly in resource-limited settings, though further controlled studies with larger sample sizes and longer follow-up are needed to assess its clinical impact.

查看原文本刊更多论文

DIBH辅导对乳腺辅助放疗患者心肺剂量学参数的影响。

导读：左侧乳腺癌妇女心脏的辐射暴露可导致心脏病和死亡率增加。包括深吸气屏气（DIBH）在内的几种技术已被用于减少放射治疗期间心脏暴露。在放射计划之前进行DIBH指导可以进一步减少心脏剂量。本研究旨在比较使用DIBH技术治疗左侧乳腺癌的训练和非训练患者的心脏和肺剂量学参数。方法：选取所有采用DIBH辅助放疗的左侧乳腺癌患者。第一组被指定为非教练组，他们接受了屏气技术的口头指导，但没有接受正式的指导。第二个队列涉及一个全面的指导协议，从2022年1月开始。该方案由一名医生领导，包括在诊所进行DIBH技术的演示和指导，并鼓励患者在RT之前和期间在家练习，以优化心脏保护。结果：符合研究纳入标准的患者共40例，平均年龄45.7±8.38岁。大多数患者为IDC和II期疾病，放疗主要采用3DCRT，剂量为4256 cGy，分16级方案。在心脏剂量暴露方面，训练组患者的平均和最大心脏点剂量略低，但这些差异无统计学意义。与未接受训练的患者相比，接受训练的患者左肺容量暴露的平均V17也显著降低（18.3 vs. 21.6, p < 0.05）。结论：在进行放射治疗计划之前进行DIBH指导和家庭实践可以进一步减少心肺剂量，提供了一种具有成本效益的干预措施，特别是在资源有限的情况下，尽管需要进一步进行更大样本量和更长随访的对照研究来评估其临床影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Pacific Journal of Cancer Prevention 医学-肿瘤学

CiteScore

2.80

自引率

0.00%

发文量

779

审稿时长

3 months

期刊介绍： Cancer is a very complex disease. While many aspects of carcinoge-nesis and oncogenesis are known, cancer control and prevention at the community level is however still in its infancy. Much more work needs to be done and many more steps need to be taken before effective strategies are developed. The multidisciplinary approaches and efforts to understand and control cancer in an effective and efficient manner, require highly trained scientists in all branches of the cancer sciences, from cellular and molecular aspects to patient care and palliation. The Asia Pacific Organization for Cancer Prevention (APOCP) and its official publication, the Asia Pacific Journal of Cancer Prevention (APJCP), have served the community of cancer scientists very well and intends to continue to serve in this capacity to the best of its abilities. One of the objectives of the APOCP is to provide all relevant and current scientific information on the whole spectrum of cancer sciences. They aim to do this by providing a forum for communication and propagation of original and innovative research findings that have relevance to understanding the etiology, progression, treatment, and survival of patients, through their journal. The APJCP with its distinguished, diverse, and Asia-wide team of editors, reviewers, and readers, ensure the highest standards of research communication within the cancer sciences community across Asia as well as globally. The APJCP publishes original research results under the following categories: -Epidemiology, detection and screening. -Cellular research and bio-markers. -Identification of bio-targets and agents with novel mechanisms of action. -Optimal clinical use of existing anti-cancer agents, including combination therapies. -Radiation and surgery. -Palliative care. -Patient adherence, quality of life, satisfaction. -Health economic evaluations.