Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold
Hayley B Stowe,1 Neal D Andruska,1 Francisco Reynoso,1 Maria Thomas,1 Carmen Bergom1– 3 1Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; 2Cardio-Oncology Center of Excellence, Washington University School of Medicine in St. Louis, St. Loui...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2022-07-01
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| Series: | Breast Cancer: Targets and Therapy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/heart-sparing-radiotherapy-techniques-in-breast-cancer-a-focus-on-deep-peer-reviewed-fulltext-article-BCTT |
| _version_ | 1811290327112220672 |
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| author | Stowe HB Andruska ND Reynoso F Thomas M Bergom C |
| author_facet | Stowe HB Andruska ND Reynoso F Thomas M Bergom C |
| author_sort | Stowe HB |
| collection | DOAJ |
| description | Hayley B Stowe,1 Neal D Andruska,1 Francisco Reynoso,1 Maria Thomas,1 Carmen Bergom1– 3 1Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; 2Cardio-Oncology Center of Excellence, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; 3Alvin J. Siteman Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USACorrespondence: Carmen Bergom, Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA, Email cbergom@wustl.eduAbstract: 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.Keywords: deep inspiration breath hold, breast cancer, radiation, active breathing control, real-time position management, heart |
| first_indexed | 2024-04-13T04:10:54Z |
| format | Article |
| id | doaj.art-4d14053d3c8d4792904f66cc69a59fcc |
| institution | Directory Open Access Journal |
| issn | 1179-1314 |
| language | English |
| last_indexed | 2024-04-13T04:10:54Z |
| publishDate | 2022-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Breast Cancer: Targets and Therapy |
| spelling | doaj.art-4d14053d3c8d4792904f66cc69a59fcc2022-12-22T03:03:07ZengDove Medical PressBreast Cancer: Targets and Therapy1179-13142022-07-01Volume 1417518676697Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath HoldStowe HBAndruska NDReynoso FThomas MBergom CHayley B Stowe,1 Neal D Andruska,1 Francisco Reynoso,1 Maria Thomas,1 Carmen Bergom1– 3 1Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; 2Cardio-Oncology Center of Excellence, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; 3Alvin J. Siteman Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USACorrespondence: Carmen Bergom, Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA, Email cbergom@wustl.eduAbstract: 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.Keywords: deep inspiration breath hold, breast cancer, radiation, active breathing control, real-time position management, hearthttps://www.dovepress.com/heart-sparing-radiotherapy-techniques-in-breast-cancer-a-focus-on-deep-peer-reviewed-fulltext-article-BCTTdeep inspiration breath holdbreast cancerradiationactive breathing controlreal-time position managementheart |
| spellingShingle | Stowe HB Andruska ND Reynoso F Thomas M Bergom C Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold Breast Cancer: Targets and Therapy deep inspiration breath hold breast cancer radiation active breathing control real-time position management heart |
| title | Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold |
| title_full | Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold |
| title_fullStr | Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold |
| title_full_unstemmed | Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold |
| title_short | Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold |
| title_sort | heart sparing radiotherapy techniques in breast cancer a focus on deep inspiration breath hold |
| topic | deep inspiration breath hold breast cancer radiation active breathing control real-time position management heart |
| url | https://www.dovepress.com/heart-sparing-radiotherapy-techniques-in-breast-cancer-a-focus-on-deep-peer-reviewed-fulltext-article-BCTT |
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