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Title: Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study

Abstract

Purpose: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). Methods and Materials: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK). The RT was given with tangential fields and a heart block. Radiation-induced cardiac perfusion and wall motion changes were assessed by pre-RT and 6-month post-RT SPECT scans. A cumulative SPECT summed-rest score was used to quantify perfusion in predefined left ventricle segments. The incidence of wall motion abnormalities was assessed in each of these same segments. Results: A total of 20 patients with normal pre-RT scans were studied; their median age was 56 years (range, 39-72 years). Seven (35%) patients also received irradiation to the left internal mammary chain, and 5 (25%) received an additional RT field to supraclavicular nodes. The median heart dose was 94 cGy (range, 56-200 cGy), and the median V25{sub Gy} was zero (range, 0-0.1). None of the patients had post-RT perfusion or wall motionmore » abnormalities. Conclusions: Our results suggest that DIBH and conformal cardiac blocking for patients receiving tangential RT for left-sided breast cancer is an effective means to avoid early RT-associated cardiac perfusion defects.« less

Authors:
 [1];  [1];  [2]; ; ; ;  [1];  [3]; ; ; ;  [4];  [1]
  1. Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)
  2. Memorial Sloan Kettering Cancer Center, West Harrison, New York (United States)
  3. Department of Radiology, Columbia University, New York, New York (United States)
  4. Department of Radiology, University of North Carolina, Chapel Hill, North Carolina (United States)
Publication Date:
OSTI Identifier:
22649878
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 97; Journal Issue: 5; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DEFECTS; DIAGNOSIS; MAMMARY GLANDS; PATIENTS; RADIOTHERAPY; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY

Citation Formats

Zagar, Timothy M., E-mail: zagar@med.unc.edu, Kaidar-Person, Orit, Tang, Xiaoli, Jones, Ellen E., Matney, Jason, Das, Shiva K., Green, Rebecca L., Sheikh, Arif, Khandani, Amir H., McCartney, William H., Oldan, Jorge Daniel, Wong, Terence Z., and Marks, Lawrence B.. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2016.12.017.
Zagar, Timothy M., E-mail: zagar@med.unc.edu, Kaidar-Person, Orit, Tang, Xiaoli, Jones, Ellen E., Matney, Jason, Das, Shiva K., Green, Rebecca L., Sheikh, Arif, Khandani, Amir H., McCartney, William H., Oldan, Jorge Daniel, Wong, Terence Z., & Marks, Lawrence B.. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study. United States. doi:10.1016/J.IJROBP.2016.12.017.
Zagar, Timothy M., E-mail: zagar@med.unc.edu, Kaidar-Person, Orit, Tang, Xiaoli, Jones, Ellen E., Matney, Jason, Das, Shiva K., Green, Rebecca L., Sheikh, Arif, Khandani, Amir H., McCartney, William H., Oldan, Jorge Daniel, Wong, Terence Z., and Marks, Lawrence B.. Sat . "Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study". United States. doi:10.1016/J.IJROBP.2016.12.017.
@article{osti_22649878,
title = {Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study},
author = {Zagar, Timothy M., E-mail: zagar@med.unc.edu and Kaidar-Person, Orit and Tang, Xiaoli and Jones, Ellen E. and Matney, Jason and Das, Shiva K. and Green, Rebecca L. and Sheikh, Arif and Khandani, Amir H. and McCartney, William H. and Oldan, Jorge Daniel and Wong, Terence Z. and Marks, Lawrence B.},
abstractNote = {Purpose: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). Methods and Materials: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK). The RT was given with tangential fields and a heart block. Radiation-induced cardiac perfusion and wall motion changes were assessed by pre-RT and 6-month post-RT SPECT scans. A cumulative SPECT summed-rest score was used to quantify perfusion in predefined left ventricle segments. The incidence of wall motion abnormalities was assessed in each of these same segments. Results: A total of 20 patients with normal pre-RT scans were studied; their median age was 56 years (range, 39-72 years). Seven (35%) patients also received irradiation to the left internal mammary chain, and 5 (25%) received an additional RT field to supraclavicular nodes. The median heart dose was 94 cGy (range, 56-200 cGy), and the median V25{sub Gy} was zero (range, 0-0.1). None of the patients had post-RT perfusion or wall motion abnormalities. Conclusions: Our results suggest that DIBH and conformal cardiac blocking for patients receiving tangential RT for left-sided breast cancer is an effective means to avoid early RT-associated cardiac perfusion defects.},
doi = {10.1016/J.IJROBP.2016.12.017},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 97,
place = {United States},
year = {Sat Apr 01 00:00:00 EDT 2017},
month = {Sat Apr 01 00:00:00 EDT 2017}
}