Ranger, A;
Dunlop, A;
Grimwood, A;
Durie, E;
Donovan, E;
Havilland, J;
Harris, E;
... Kirby, AM; + view all
(2021)
Voluntary versus ABC breath-hold in the context of VMAT for breast and locoregional lymph node radiotherapy including the internal mammary chain.
Clinical and Translational Radiation Oncology
, 27
pp. 164-168.
10.1016/j.ctro.2021.02.003.
Preview |
Text
1-s2.0-S2405630821000173-main.pdf - Published Version Download (591kB) | Preview |
Abstract
Background: Deep-inspiration breath-hold (DIBH) reduces radiation dose to the heart in patients undergoing locoregional breast radiotherapy. In the context of tangential irradiation of the breast/ chest wall, a voluntary breath hold (vDIBH) technique has been shown to be as reproducible as a machine-assisted breath hold technique using the active breathing co-ordinator (ABCTM, Elekta, Crawley, UK, ABC_DIBH). This study compares set-up reproducibility for vDIBH versus ABC_DIBH in patients undergoing volumetric-modulated arc radiotherapy (VMAT) for breast cancer, both with and without wax bolus. Method: Patients with breast cancer requiring pan regional lymph node VMAT +/� wax bolus in breathhold were CT scanned in vDIBH and ABC_DIBH. Patients were randomised to receive one technique for fractions 1–7 and the other for fractions 8–15. Daily cone beam computed tomography (CBCT) was performed and registered to planning-CT using bony anatomy. Within-patient comparisons of mean daily chest wall position were made using a paired t-test. Population, systematic (P) and random errors (a) were estimated. Intrafraction reproducibility was assessed by comparing chest wall position and diaphragm movement between consecutive breath holds on CBCT. Results: 16 patients were recruited. All completed treatment with both techniques (9 patients with wax bolus, 7 patients without). CBCT derived P were 2.1–6.4 mm (ABC_DIBH) and 2.1–4.9 mm (vDIBH), a were 1.7–2.6 mm (ABC_DIBH) and 2.2–2.7 mm (vDIBH) and mean daily chest wall displacements (MD) were 0.0–1.5 mm (ABC_DIBH) and - 0.1–1.6 vDIBH (all p non-significant). Chest wall and diaphragm position was equivalent between consecutive breath holds in ABC and vDIBH (median difference 1.0 mm and 0.8 mm respectively, non p significant) demonstrating equivalent intrafraction reproducibility. Conclusion: This study demonstrates that a simple voluntary breath hold technique is feasible in combination with VMAT (+/� bolus) and is as reproducible as ABC_DIBH with VMAT for the irradiation of the breast and axillary and IMC lymph nodes in breast cancer patients.
| Type: | Article |
|---|---|
| Title: | Voluntary versus ABC breath-hold in the context of VMAT for breast and locoregional lymph node radiotherapy including the internal mammary chain |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ctro.2021.02.003 |
| Publisher version: | http://doi.org/10.1016/j.ctro.2021.02.003 |
| Language: | English |
| Additional information: | This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
| Keywords: | Breast radiotherapy, Heart sparing, Internal mammary chain, VMAT, Voluntary breath hold |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10123799 |
Loading...
Loading...Loading...Loading...Archive Staff Only
 |
View Item |
