Dosimetric Comparison of Voluntary Deep Breath-Holding and Free Breathing Techniques in Left Breast Cancer Patients Receiving Radiotherapy

Radyoterapi Alan Sol Meme Kanseri Hastalarında Gönüllü Derin Nefes Tutma ve Serbest Solunum Teknikleri Uygulamalarının Dozimetrik Olarak Karşılaştırılması

Abstract

The aim of this prospective study is to examine the advantages and disadvantages of using DIBH technique by comparing the dose-volume histograms (DVH) of voluntary deep breath holding (DIBH) and free breathing (FB) techniques that are among the modern techniques in the treatment of left breast cancer. Treatment plans were made with a total dose of 50 Gy, as to be a daily fraction of 2 Gy through the ”Real-Time Position Management Respiratory Gating System” (RPM) system. When we compared the mean critical organ doses in both groups, the largest dose reductions in the DIBH technique were observed in the heart (6,7 Gy to 2,19 Gy; p=0.007) and LAD (23,28 Gy to 12,42 Gy; p=0.007). When the DIBH and FB techniques are concerned, although there was a significant increase in the total lung (p=0.002) and the left lung (p=0.0001) in terms of volume; in the comparison made about mean doses, the volume of the lung (V20) that received a dose of 20 Gy,a small volumetric decrease was observed in the total lung (p=0.508) and the left lung (p=0.541). With the DIBH technique, advantage has been obtained in terms of heart, LAD and lung doses without compromising the dose of the target.