Details

Autor(en) / Beteiligte

• Bartlett, Frederick R
• Colgan, Ruth M
• Carr, Karen
• Donovan, Ellen M
• McNair, Helen A
• Locke, Imogen
• Evans, Philip M
• Haviland, Joanne S
• Yarnold, John R
• Kirby, Anna M

Titel

The UK HeartSpare Study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy

Ist Teil von

• Radiotherapy and oncology, 2013-08, Vol.108 (2), p.242-247

Ort / Verlag

Ireland: Elsevier Ireland Ltd

Erscheinungsjahr

2013

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Abstract Purpose To determine whether voluntary deep-inspiratory breath-hold (v_DIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABC_DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery. Methods Following surgery for early breast cancer, patients underwent planning-CT scans in v_DIBH and ABC_DIBH. Patients were randomised to receive one technique for fractions 1–7 and the second technique for fractions 8–15 (40 Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic ( Σ ) and random errors ( σ ) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t -test or Wilcoxon signed-rank test. Results Twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived Σ were ⩽1.8 mm (v_DIBH) and ⩽2.0 mm (ABC_DIBH) and σ ⩽2.5 mm (v_DIBH) and ⩽2.2 mm (ABC_DIBH) (all p non-significant). CBCT-derived Σ were ⩽3.9 mm (v_DIBH) and ⩽4.9 mm (ABC_DIBH) and σ ⩽ 4.1 mm (v_DIBH) and ⩽ 3.8 mm (ABC_DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v_DIBH ( p = 0.007, p = 0.03, respectively). Scanning/treatment setup times were shorter for v_DIBH ( p = 0.02, p = 0.04, respectively). Conclusions v_DIBH and ABC_DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v_DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC_DIBH.