China
Africa
Explore chapters and articles related to this topic
SGRT for Proton Therapy
Published in Jeremy D. P. Hoisak, Adam B. Paxton, Benjamin Waghorn, Todd Pawlicki, Surface Guided Radiation Therapy, 2020
Deep inspiration breath hold (DIBH) is another form of respiratory motion management commonly used for left-sided breast cancer patients to limit heart dose. SGRT has been shown to be an effective method for confirming DIBH levels are as intended during linac-based treatments and was reviewed in Chapter 10. Proton therapy alone is another treatment technique that can spare dose to the heart because protons deposit all their dose in tissue and have no exit dose.19 However, there can still be situations in which the position of the heart for a particular patient may be immediately adjacent to the chest wall. Due to the range uncertainties associated with proton treatment, the desired dose to the heart may not be achievable with proton therapy when treating the patient under free breathing conditions. For these situations, DIBH techniques could also be used for proton treatments. Mutter et al.14 reported utilizing SGRT to help accommodate the DIBH delivery of a proton treatment to a chest wall patient to help displace the heart posteriorly and caudally away from the chest wall and internal mammary lymph node target.
Application of IGRT for lung stereotactic body radiotherapy
Published in Jing Cai, Joe Y. Chang, Fang-Fang Yin, Principles and Practice of Image-Guided Radiation Therapy of Lung Cancer, 2017
Julianne M. Pollard-Larkin, Peter Balter, Joe Y. Chang
The choice to treat with inhale or exhale should be made based on the changes in the tumor position and the normal anatomy. Typically, deep-inspiration breath-hold (DIBH) is chosen for breath-hold simulation and treatments in lung cases since it increases the distance between target and critical structures [2].
Real-time tumor tracking
Published in Ross I. Berbeco, Beam’s Eye View Imaging in Radiation Oncology, 2017
Intrafractional motion in radiotherapy of the left breast can increase the heart dose, which may lead to coronary artery disease. For deep inspiration breath hold (DIBH) techniques the patient is asked to inhale and then hold the breath while the radiation is delivered. DIBH can maximize the distance between the treatment target and the heart and therefore minimize the heart dose (Yeung et al. 2015). Tracking the chest wall during treatment delivery has been shown to be a useful tool to ensure that the planned motion tolerances are met during therapy delivery (Jensen et al. 2014).
Dosimetric evaluation of the benefit of deep inspiration breath hold (DIBH) for locoregional irradiation of right breast cancer with volumetric modulated arctherapy (VMAT)
Published in Acta Oncologica, 2023
Pierre Loap, Jeremi Vu-Bezin, Virginie Monceau, Sophie Jacob, Alain Fourquet, Youlia Kirova
Technical progresses have been made to improve cardiac sparing for breast locoregional irradiation. Such advances include highly conformal techniques such as volumetric modulated arctherapy (VMAT) or helical tomotherapy [11], deep-inspiration breath-hold (DIBH) [13], and intensity modulated proton therapy (IMPT) [14–16]. The cardiac dosimetric benefit of DIBH for left breast cancer (L-BC) locoregional irradiation with VMAT has been demonstrated [11,17,18]. More recently, a dosimetric study focusing on R-BC locoregional radiotherapy with a classic 3D technique suggested that DIBH could possibly provide an additional cardiac dosimetric benefit, in addition to lung and liver dose reduction [19]. However, when using modern highly-conformal cardiac-sparing techniques for R-BC such as VMAT, the additional benefit of DIBH is uncertain. In the department of Radiation Oncology (Institut Curie, Paris, France), R-BC locoregional irradiation with DIBH-VMAT was proposed in some specific situations; this study aimed to evaluate the dosimetric benefit of DIBH for locoregional irradiation of R-BC with VMAT in those patients.
Baseline FDG PET/CT in free breathing versus deep inspiration breath-hold for pediatric patients with mediastinal lymphoma
Published in Acta Oncologica, 2022
Anni Young Lundgaard, Danijela Dejanovic, Anne Kiil Berthelsen, Flemming Littrup Andersen, Laura Ann Rechner, Lise Borgwardt, Lisa Lyngsie Hjalgrim, Lena Specht, Maja Vestmø Maraldo
In 2017, we initiated a combined feasibility study and the first prospective clinical trial to introduce radiotherapy delivery in deep inspiration for pediatric patients – the TEDDI protocol (NCT03315546) [18]. The protocol aims to investigate the dosimetric benefit (a surrogate marker for the potential clinical benefit) of radiotherapy delivery using DIBH compared to free breathing (FB). In adult patient the reduced radiation doses to the heart and lungs with radiotherapy in DIBH are primarily due to the anatomical changes in DIBH, i.e. an inflation of the lungs and a caudal and posterior displacement of the heart [12,19]. However, for young children the anatomical changes or the breathing patterns might be less pronounced than for adults diminishing the dosimetric advantage of DIBH for children.
Reproducibility of heart and thoracic wall position in repeated deep inspiration breath holds for radiotherapy of left-sided breast cancer patients
Published in Acta Oncologica, 2018
Kenneth Wikström, Ulf Isacsson, Kristina Nilsson, Anders Ahnesjö
For left-sided breast cancer radiotherapy, deep inspiration breath hold (DIBH) treatments can reduce the dose to the heart in a simple and effective way by increasing the distance between the heart and the treated breast. Since treatment delivery time is longer than the breath-hold time, the treatment is distributed over several DIBH periods with free-breathing in between. The breathing motion, and related breath hold levels, can be measured in several ways, e.g. through monitoring tidal volume with a spirometer [6], monitoring a light reflecting box on the chest [7], or patient contour monitoring by a surface scanning system [8,9]. In all methods, a patient-specific gating window must be defined prior or during the acquisition of the planning CT to give a reference for reproduction of the breath hold position.