Factors Affecting the Effectiveness of DIBH (Deep Inspiratory Breath Hold) in Patients with Left Breast Cancer: A Narrative Review
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Training and Patient Education before DIBH
3.2. Patients Awareness and Motivation to DIBH
3.3. Positioning Patients on Their Prone Position Compared to the Supine Positioning
3.4. Individual Anatomical Characteristics of the Patient
3.4.1. Age
3.4.2. Cardiovascular Risk Factors
Diabetes
Smoking
Hypertension
3.5. Other Factors
- IMRT, VMAT, proton techniques vs. DIBH
- Use of CPAP as an adjunct to DIBH
- ABC
- BCS/Mastectomy
- BMI
4. Limitations of the Review
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- DeSantis, C.E.; Ma, J.; Gaudet, M.M.; Newman, L.A.; Miller, K.D.; Goding Sauer, A.; Jemal, A.; Siegel, R.L. Breast cancer statistics. CA Cancer J. Clin. 2019, 69, 438–451. [Google Scholar] [CrossRef]
- Kunkler, I.H.; Chua, B.H. Postmastectomy radiotherapy: A review. Curr. Opin. Oncol. 2021, 33, 547–552. [Google Scholar] [CrossRef] [PubMed]
- Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: Meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 2011, 378, 1707–1716. [Google Scholar] [CrossRef]
- Bergom, C.; Currey, A.; Desai, N.; Tai, A.; Strauss, J.B. Deep Inspiration Breath Hold: Techniques and Advantages for Cardiac Sparing During Breast Cancer Irradiation. Front. Oncol. 2018, 8, 87. [Google Scholar] [CrossRef]
- Gaál, S.; Kahán, Z.; Paczona, V.; Kószó, R.; Drencsényi, R.; Szabó, J.; Rónai, R.; Antal, T.; Deák, B.; Varga, Z. Deep-inspirational breath-hold (DIBH) technique in left-sided breast cancer: Various aspects of clinical utility. Radiat. Oncol. 2021, 16, 89. [Google Scholar] [CrossRef] [PubMed]
- Duma, M.N.; Baumann, R.; Budach, W.; Dunst, J.; Feyer, P.; Fietkau, R.; Haase, W.; Harms, W.; Hehr, T.; Krug, D.; et al. Heart-sparing radiotherapy techniques in breast cancer patients: A recommendation of the breast cancer expert panel of the German society of radiation oncology (DEGRO). Strahlenther. Onkol. 2019, 195, 861–871. [Google Scholar] [CrossRef]
- Stowe, H.B.; Andruska, N.D.; Reynoso, F.; Thomas, M.; Bergom, C. Heart Sparing Radiotherapy Techniques in Breast Cancer: A Focus on Deep Inspiration Breath Hold. Breast Cancer 2022, 14, 175–186. [Google Scholar] [CrossRef]
- Sakka, M.; Kunzelmann, L.; Metzger, M.; Grabenbauer, G.G. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation: Is IMRT more beneficial than VMAT? Strahlenther. Onkol. 2017, 193, 800–811. [Google Scholar] [CrossRef]
- Schröder, C.; Kirschke, S.; Blank, E.; Rohrberg, S.; Förster, R.; Buchali, A. Deep inspiration breath-hold for patients with left-sided breast cancer—A one-fits-all approach? A prospective analysis of patient selection using dosimetrical and practical aspects. Br. J. Radiol. 2022, 95, 20210295. [Google Scholar] [CrossRef]
- Goyal, U.; Saboda, K.; Roe, D.; Gonzalez, V.J. Prone Positioning with Deep Inspiration Breath Hold for Left Breast Radiotherapy. Clin. Breast Cancer 2021, 21, e295–e301. [Google Scholar] [CrossRef]
- Romera-Martínez, I.; Muñoz-Montplet, C.; Jurado-Bruggeman, D.; Onsès-Segarra, A.; Fuentes-Raspall, R.; Buxó, M.; Vilanova, J.C. A Novel Device for Deep-Inspiration Breath Hold (DIBH): Results from a Single-Institution Phase 2 Clinical Trial for Patients with Left-Sided Breast Cancer. Pract. Radiat. Oncol. 2020, 10, e290–e297. [Google Scholar] [CrossRef] [PubMed]
- Lai, J.; Zhong, F.; Deng, J.; Hu, S.; Shen, R.; Luo, H.; Luo, Y. Prone position versus supine position in postoperative radiotherapy for breast cancer: A meta-analysis. Medicine 2021, 100, e26000. [Google Scholar] [CrossRef] [PubMed]
- Lu, Y.; Yang, D.; Zhang, X.; Teng, Y.; Yuan, W.; Zhang, Y.; He, R.; Tang, F.; Pang, J.; Han, B.; et al. Comparison of Deep Inspiration Breath Hold Versus Free Breathing in Radiotherapy for Left Sided Breast Cancer. Front. Oncol. 2022, 12, 845037. [Google Scholar] [CrossRef] [PubMed]
- Desai, N.; Currey, A.; Kelly, T.; Bergom, C. Nationwide Trends in Heart-Sparing Techniques Utilized in Radiation Therapy for Breast Cancer. Adv. Radiat. Oncol. 2019, 4, 246–252. [Google Scholar] [CrossRef] [PubMed]
- Pandeli, C.; Smyth, L.M.L.; David, S.; See, A.W. Dose reduction to organs at risk with deep-inspiration breath-hold during right breast radiotherapy: A treatment planning study. Radiat. Oncol. 2019, 14, 223. [Google Scholar] [CrossRef] [PubMed]
- Simonetto, C.; Eidemüller, M.; Gaasch, A.; Pazos, M.; Schönecker, S.; Reitz, D.; Kääb, S.; Braun, M.; Harbeck, N.; Niyazi, M.; et al. Does deep inspiration breath-hold prolong life? Individual risk estimates of ischaemic heart disease after breast cancer radiotherapy. Radiother. Oncol. 2019, 131, 202–207. [Google Scholar] [CrossRef] [PubMed]
- Lai, J.; Hu, S.; Luo, Y.; Zheng, R.; Zhu, Q.; Chen, P.; Chi, B.; Zhang, Y.; Zhong, F.; Long, X. Meta-analysis of deep inspiration breath hold (DIBH) versus free breathing (FB) in postoperative radiotherapy for left-side breast cancer. Breast Cancer 2020, 27, 299–307. [Google Scholar] [CrossRef]
- Liang, E.; Dolan, J.L.; Morris, E.D.; Vono, J.; Bazan, L.F.; Lu, M.; Glide-Hurst, C.K. Application of Continuous Positive Airway Pressure for Thoracic Respiratory Motion Management: An Assessment in a Magnetic Resonance Imaging-Guided Radiation Therapy Environment. Adv. Radiat. Oncol. 2022, 7, 100889. [Google Scholar] [CrossRef]
- Kim, A.; Kalet, A.M.; Cao, N.; Hippe, D.S.; Fang, L.C.; Young, L.; Meyer, J.; Lang, E.V.; Mayr, N.A. Effects of Preparatory Coaching and Home Practice for Deep Inspiration Breath Hold on Cardiac Dose for Left Breast Radiation Therapy. Clin. Oncol. (R. Coll Radiol.) 2018, 30, 571–577. [Google Scholar] [CrossRef]
- Salvestrini, V.; Iorio, G.C.; Borghetti, P.; De Felice, F.; Greco, C.; Nardone, V.; Fiorentino, A.; Gregucci, F.; Desideri, I. The impact of modern radiotherapy on long-term cardiac sequelae in breast cancer survivor: A focus on deep inspiration breath-hold (DIBH) technique. J. Cancer Res. Clin. Oncol. 2022, 148, 409–417. [Google Scholar] [CrossRef]
- Dell’Oro, M.; Giles, E.; Sharkey, A.; Borg, M.; Connell, C.; Bezak, E. A Retrospective Dosimetric Study of Radiotherapy Patients with Left-Sided Breast Cancer; Patient Selection Criteria for Deep Inspiration Breath Hold Technique. Cancers 2019, 11, 259. [Google Scholar] [CrossRef]
- Browne, P.; Beaton, N.R.; Sharma, H.; Watson, S.; Mai, G.T.; Harvey, J.; Bernard, A.; Brown, E.; Hargrave, C.; Lehman, M. Identifying breast cancer patients who gain the most dosimetric benefit from deep inspiration breath hold radiotherapy. J. Med. Radiat. Sci. 2020, 67, 294–301. [Google Scholar] [CrossRef]
- Aznar, M.C.; Carrasco de Fez, P.; Corradini, S.; Mast, M.; McNair, H.; Meattini, I.; Persson, G.; van Haaren, P. ESTRO-ACROP guideline: Recommendations on implementation of breath-hold techniques in radiotherapy. Radiother. Oncol. 2023, 185, 109734. [Google Scholar] [CrossRef] [PubMed]
- Mayr, N.A.; Borm, K.J.; Kalet, A.M.; Wootton, L.S.; Chadderdon, A.L.; Combs, S.E.; Wang, W.; Cao, N.; Lo, S.S.; Sandison, G.A.; et al. Reducing Cardiac Radiation Dose from Breast Cancer Radiation Therapy with Breath Hold Training and Cognitive Behavioral Therapy. Top. Magn. Reson. Imaging 2020, 29, 135–148. [Google Scholar] [CrossRef]
- Oonsiri, P.; Wisetrinthong, M.; Chitnok, M.; Saksornchai, K.; Suriyapee, S. An effective patient training for deep inspiration breath hold technique of left-sided breast on computed tomography simulation procedure at King Chulalongkorn Memorial Hospital. Radiat. Oncol. J. 2019, 37, 201–206. [Google Scholar] [CrossRef]
- Zhao, F.; Shen, J.; Lu, Z.; Luo, Y.; Yao, G.; Bu, L.; Ge, J.; Yang, X.; Ning, L.; Yan, S. Abdominal DIBH reduces the cardiac dose even further: A prospective analysis. Radiat. Oncol. 2018, 13, 116. [Google Scholar] [CrossRef]
- Kil, W.J.; Pham, T.; Kim, K. Heart sparing breast cancer radiotherapy using continuous positive airway pressure (CPAP) and conventional supine tangential fields: An alternative method for patients with limited accessibility to advanced radiotherapy techniques. Acta Oncol. 2019, 58, 105–109. [Google Scholar] [CrossRef] [PubMed]
- Wang, X.; Fargier-Bochaton, O.; Dipasquale, G.; Laouiti, M.; Kountouri, M.; Gorobets, O.; Nguyen, N.P.; Miralbell, R.; Vinh-Hung, V. Is prone free breathing better than supine deep inspiration breath-hold for left whole-breast radiotherapy? A dosimetric analysis. Strahlenther. Onkol. 2021, 197, 317–331. [Google Scholar] [CrossRef] [PubMed]
- Alonso, C.; Janowski, E.; Libby, B.; Showalter, S. Comparison of heart dose in early-stage left-sided breast cancers treated with intraoperative radiation therapy or whole-breast irradiation with deep inspiratory breath hold. Brachytherapy 2018, 17, 831–836. [Google Scholar] [CrossRef]
- Cao, N.; Kalet, A.M.; Young, L.A.; Fang, L.C.; Kim, J.N.; Mayr, N.A.; Meyer, J. Predictors of cardiac and lung dose sparing in DIBH for left breast treatment. Phys. Med. 2019, 67, 27–33. [Google Scholar] [CrossRef]
- Cunningham, L.; Penfold, S.; Giles, E.; Le, H.; Short, M. Impact of Breast Size on Dosimetric Indices in Proton Versus X-ray Radiotherapy for Breast Cancer. J. Pers. Med. 2021, 11, 282. [Google Scholar] [CrossRef]
- Mahmoud, A.A.; Sadaka, E.A.; Abouegylah, M.; Amin, S.A.; Elmansy, H.; Asal, M.F.; Köksal, M.A.; Gawish, A. Impact of breath-hold technique on incidence of cardiac events in adjuvant left breast cancer irradiation. J. Cancer Res. Clin. Oncol. 2023, 149, 5853–5859. [Google Scholar] [CrossRef]
- Gaasch, A.; Schönecker, S.; Simonetto, C.; Eidemüller, M.; Pazos, M.; Reitz, D.; Rottler, M.; Freislederer, P.; Braun, M.; Würstlein, R.; et al. Heart sparing radiotherapy in breast cancer: The importance of baseline cardiac risks. Radiat. Oncol. 2020, 15, 117. [Google Scholar] [CrossRef]
- Lee, M.S.; Liu, D.W.; Hung, S.K.; Yu, C.C.; Chi, C.L.; Chiou, W.Y.; Chen, L.C.; Lin, R.I.; Huang, L.W.; Chew, C.H.; et al. Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care. Front. Cardiovasc. Med. 2020, 7, 16. [Google Scholar] [CrossRef]
- Piroth, M.D.; Baumann, R.; Budach, W.; Dunst, J.; Feyer, P.; Fietkau, R.; Haase, W.; Harms, W.; Hehr, T.; Krug, D.; et al. Heart toxicity from breast cancer radiotherapy: Current findings, assessment, and prevention. Strahlenther. Onkol. 2019, 195, 1–12. [Google Scholar] [CrossRef] [PubMed]
- Mkanna, A.; Mohamad, O.; Ramia, P.; Thebian, R.; Makki, M.; Tamim, H.; Jalbout, W.; Youssef, B.; Eid, T.; Geara, F.; et al. Predictors of Cardiac Sparing in Deep Inspiration Breath-Hold for Patients with Left Sided Breast Cancer. Front. Oncol. 2018, 8, 564. [Google Scholar] [CrossRef] [PubMed]
- Jacobse, J.N.; Duane, F.K.; Boekel, N.B.; Schaapveld, M.; Hauptmann, M.; Hooning, M.J.; Seynaeve, C.M.; Baaijens, M.H.A.; Gietema, J.A.; Darby, S.C.; et al. Radiation Dose-Response for Risk of Myocardial Infarction in Breast Cancer Survivors. Int. J. Radiat. Oncol. Biol. Phys. 2019, 103, 595–604. [Google Scholar] [CrossRef]
- Lu, Y.; Ma, Y.; Yang, D.; Li, Y.; Yuan, W.; Tang, F.; Xu, L.; Zhou, L.; Lin, H.; Li, B.; et al. Cardiorespiratory dose comparison among six radiotherapy regimens for patients with left-sided breast cancer. Sci. Rep. 2023, 13, 13339. [Google Scholar] [CrossRef] [PubMed]
- Patel, C.G.; Peterson, J.; Aznar, M.; Tseng, Y.D.; Lester, S.; Pafundi, D.; Flampouri, S.; Mohindra, P.; Parikh, R.R.; Mailhot Vega, R.; et al. Systematic review for deep inspiration breath hold in proton therapy for mediastinal lymphoma: A PTCOG Lymphoma Subcommittee report and recommendations. Radiother. Oncol. 2022, 177, 21–32. [Google Scholar] [CrossRef] [PubMed]
- Everett, A.S.; Hoppe, B.S.; Louis, D.; McDonald, A.M.; Morris, C.G.; Mendenhall, N.P.; Li, Z.; Flampouri, S. Comparison of Techniques for Involved-Site Radiation Therapy in Patients with Lower Mediastinal Lymphoma. Pract. Radiat. Oncol. 2019, 9, 426–434. [Google Scholar] [CrossRef] [PubMed]
- Pazos, M.; Schönecker, S.; Reitz, D.; Rogowski, P.; Niyazi, M.; Alongi, F.; Matuschek, C.; Braun, M.; Harbeck, N.; Belka, C.; et al. Recent Developments in Radiation Oncology: An Overview of Individualised Treatment Strategies in Breast Cancer. Breast Care 2018, 13, 285–291. [Google Scholar] [CrossRef] [PubMed]
- All, S.; Zhao, B.; Montalvo, S.; Maxwell, C.; Johns, C.; Gu, X.; Rahimi, A.; Alluri, P.; Parsons, D.; Chiu, T.; et al. Feasibility and efficacy of active breathing coordinator assisted deep inspiration breath hold technique for treatment of locally advanced breast cancer. J. Appl. Clin. Med. Phys. 2023, 24, e13893. [Google Scholar] [CrossRef] [PubMed]
- Misra, S.; Mishra, A.; Lal, P.; Srivastava, R.; Verma, M.; Senthil Kumar, S.K.; Das, K.J.M. Cardiac dose reduction using deep inspiratory breath hold (DIBH) in radiation treatment of left sided breast cancer patients with breast conservation surgery and modified radical mastectomy. J. Med. Imaging Radiat. Sci. 2021, 52, 57–67. [Google Scholar] [CrossRef]
Reference | Study Type | N | Year | Risk Factors |
---|---|---|---|---|
Gaál S et al. [5] | Cross-sectional study | 130 | 2021 | Age, cardiovascular risk factors, and smoking |
Lee MS et al. [34] | Systematic review | 2020 | Prior cardiovascular disease, diabetes, COPD, smoking history, and high BMI | |
Gaasch A et al. [33] | Prospective cohort study | 210 | 2020 | The evaluated parameters included smoking behavior, history of diabetes mellitus, antihypertensive therapy, and family history of cardiovascular disease. If available, CRP and cholesterol levels (LDL, HDL, triglycerides) were reported. |
Piroth MD et al. [35] | Systematic review | 2019 | History of ischemic heart disease, diabetes, chronic obstructive pulmonary disease, smoking, body mass index ≥ 30 kg/m2, arterial hypertension, dyslipidemia | |
Simonetto C et al. [16] | Prospective cohort study | 89 | 2019 | Age; individual coronary heart disease mortality risks can be estimated by the SCORE prediction formula. SCORE takes into account the following individual risk factors: cholesterol level, systolic blood pressure, and smoking. |
Mahmoud AA et al. [32] | Prospective cohort study | 432 | 2023 | Age, diabetes, hypertension, smoking |
Mkanna A et al. [36] | Prospective cohort study | 103 | 2018 | Age, body mass index, and smoking status, in addition to medical co-morbidities CHF, prior chest surgery, prior lung disease, or presence of simultaneous psychiatric conditions |
Jacobse JN et al. [37] | Cross-sectional study | 183 | 2019 | Prior cardiovascular diseases, diabetes, hypertension, smoking history, and BMI |
Dell’Oro M et al. [21] | Retrospective dosimetric study | 20 | 2019 | Age, BMI |
Potential Factor | Reference | Citation | Year | Short Description of the Study | Effectiveness of DIBH Conclusions |
---|---|---|---|---|---|
Training and patient education | A Kim | [19] | 2018 | Effects of Preparatory Coaching on the DIBH treatment | The benefits of DIBH are achieved by patients who have received adequate training and education prior to radiation therapy, which helps minimize cardiac complications and shorten treatment times. |
Marianne Camille Aznar | [23] | 2023 | Implementation of breath-hold techniques | ||
Nina A Mayr | [24] | 2020 | Cardiac radiation dose after DIBH | ||
Puntiwa Oonsiri | [25] | 2019 | An effective patient training for DIBH | ||
Feng Zhao | [26] | 2018 | Abdominal DIBH- OAR dose reduction | ||
Romera-Martínez I | [11] | 2020 | Clinical trial with DIBH | ||
Patient’s awareness and motivation | Nina A Mayr | [24] | 2020 | Cardiac radiation dose after DIBH | The benefits of DIBH are achieved by patients with a high level of health consciousness who understand the importance of performing the DIBH technique correctly and do not have problems with anxiety or other mental disorders. |
Christina Schröder | [9] | 2022 | A patient selection using dosimetric and practical DIBH | ||
Szilvia Gaál | [5] | 2021 | Various aspects of clinical utility of DIBH | ||
Cristoforo Simonetto | [16] | 2018 | Individual risk estimates of ischemic heart disease | ||
Whoon Jong Kil | [27] | 2019 | CPAP and conventional supine tangential fields | ||
Patients positioning | Uma Goyal | [10] | 2020 | Clinical trial on prone positioning | The benefits of using DIBH also depend on patient positioning: Position on the stomach (P-DIBH): Patients with smaller breasts Back position (S-DIBH): Patients with larger breasts |
Junming Lai | [12] | 2021 | Prone position versus supine position during DIBH | ||
Nina Desai | [14] | 2019 | DIBH radiation dose to the heart | ||
Junming Lai | [17] | 2020 | DIBH versus free breathing | ||
Xinzhuo Wang | [28] | 2021 | Prone versus supine DIBH | ||
Carmen Bergom | [4] | 2018 | Advantages of cardiac sparing during DIBH | ||
Hayley B Stowe | [7] | 2022 | Radiotherapy techniques in breast cancer | ||
Clayton Alonso | [29] | 2018 | Clinical trial on comparison of heart radiation dose | ||
Marc D. Piroth | [35] | 2019 | DIBH heart toxicity | ||
Age | Mikaela Dell’Oro | [21] | 2019 | Patient Selection Criteria for DIBH | Benefits of using DIBH for younger patients who are able to perform the breath-hold technique more accurately, resulting in better patient outcomes and minimizing the risk of cardiac complications. |
Cristoforo Simonetto | [16] | 2018 | Individual risk estimates of ischemic heart disease | ||
Amr A Mahmoud | [32] | 2022 | Irradiation incidence of cardiac events | ||
Szilvia Gaál | [5] | 2021 | Various aspects of clinical utility of DIBH | ||
Anatomical characteristics | Carmen Bergom | [4] | 2018 | Advantages for cardiac sparing during DIBH | DIBH benefits patients with the right anatomical parameters, such as increased maximum heart distance (MHD) from the treatment area. Larger ciliary contact distances (CCD ps and CCD ax) to the heart. Larger lateral distance of the heart from the chest (HCD). Smaller breast size. |
Mikaela Dell’Oro | [21] | 2019 | Patient Selection Criteria for DIBH | ||
Ning Cao | [30] | 2019 | DIBH cardiac and lung dose | ||
Lisa Cunningham | [31] | 2021 | Impact of breast size during DIBH | ||
Uma Goyal | [10] | 2020 | Clinical trial about prone positioning | ||
Junming Lai | [17] | 2020 | DIBH versus free breathing | ||
Hayley B Stowe | [7] | 2022 | Radiotherapy techniques in breast cancer | ||
Amr A Mahmoud | [32] | 2022 | Irradiation incidence of cardiac events | ||
Diabetes | Moon-Sing Lee | [34] | 2020 | DIBH cardiovascular dysfunction | DIBH benefits patients without diabetes who have a significantly lower risk of cardiovascular complications after radiation therapy. Although DIBH can reduce the radiation dose to the heart in patients with diabetes, they are still at higher risk of complications than those without diabetes |
Aurélie Gaasch | [33] | 2020 | Importance of baseline cardiac risks | ||
Hypertension | Amr A Mahmoud | [32] | 2022 | Irradiation incidence of cardiac events | DIBH benefits patients with well-controlled hypertension who have a lower risk of ischemic heart disease after radiation therapy. Patients with untreated or poorly controlled hypertension are at higher risks of cardiovascular complications. |
Moon-Sing Lee | [34] | 2020 | DIBH cardiovascular dysfunction | ||
Aurélie Gaasch | [33] | 2020 | Importance of baseline cardiac risks | ||
Smoking | Amr A Mahmoud | [32] | 2022 | Irradiation incidence of cardiac events | Non-smoking patients benefit from DIBH, as smoking significantly increases the risk of ischemic heart disease and other cardiovascular complications after radiation therapy |
Aurélie Gaasch | [33] | 2020 | Importance of baseline cardiac risks | ||
Marc D Piroth | [35] | 2019 | DIBH heart toxicity | ||
Szilvia Gaál | [5] | 2021 | Various aspects of clinical utility of DIBH | ||
Cristoforo Simonetto | [16] | 2018 | Individual risk estimates of ischemic heart disease | ||
IMRT, VMAT, proton techniques vs. DIBH | Marc D. Piroth | [35] | 2019 | DIBH heart toxicity | Combining DIBH with IMRT: Patients with minimal or well-controlled respiratory motion, which will allow for the full benefit of IMRT to be realized in terms of conformal dose delivery, while minimizing the impact of organ motion. VMAT: Patients in whom respiratory motion may affect the accuracy of radiotherapy, as VMAT better accommodates motion dynamics. Proton therapy: Patients in whom minimizing the total radiation dose to surrounding tissues is a priority. |
V Salvestrini | [20] | 2022 | Modern radiotherapy on long-term cardiac sequelae | ||
Yongkai Lu | [38] | 2023 | DIBH cardiorespiratory dose | ||
Patel | [39] | 2022 | DIBH therapy for mediastinal lymphoma | ||
Ashlyn S Everett | [40] | 2019 | Techniques for Involved-Site Radiation Therapy | ||
Mazen Sakka | [8] | 2018 | IMRT more beneficial than VMAT? | ||
Montserrat Pazos | [41] | 2018 | Individualized treatment strategies in breast cancer | ||
Use of CPAP | Evan Liang | [18] | 2022 | Positive airway pressure for thoracic respiratory motion management | Patients with thoracic tumors who have significant respiratory motion, as CPAP can reduce the amplitude of respiratory motion and improve the accuracy of radiation therapy. |
ABC | Sean All | [42] | 2023 | Efficacy of active breathing coordinator-assisted DIBH | In patients who require repetitive chest movements during DIBH because the ABC system provides precise and reproducible treatment conditions. |
BCS/Mastectomy | Yongkai Lu | [13] | 2022 | DIBH versus free breathing in radiotherapy | Post-mastectomy patients may benefit more from DIBH compared to BCS patients |
Sean All | [42] | 2023 | Feasibility and efficacy of active breathing coordinator | ||
Shagun Misra | [43] | 2021 | Cardiac dose reduction using DIBH | ||
BMI | Mikaela Dell’Oro | [21] | 2019 | Patient Selection Criteria for DIBH | Patients with a higher BMI may show a greater difference in mean heart dose (MHDD) between FB and DIBH treatment plans. This means that DIBH may more effectively protect the heart from radiation in patients with a higher BMI. |
Marianne Camille Aznar | [23] | 2023 | Implementation of breath-hold techniques in radiotherapy | ||
Sean All | [42] | 2023 | Feasibility and efficacy of active breathing coordinator |
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Hanczyk, E.; Piecuch, D.; Kopcial, S.; Jonska-Gmyrek, J. Factors Affecting the Effectiveness of DIBH (Deep Inspiratory Breath Hold) in Patients with Left Breast Cancer: A Narrative Review. Appl. Sci. 2024, 14, 7287. https://doi.org/10.3390/app14167287
Hanczyk E, Piecuch D, Kopcial S, Jonska-Gmyrek J. Factors Affecting the Effectiveness of DIBH (Deep Inspiratory Breath Hold) in Patients with Left Breast Cancer: A Narrative Review. Applied Sciences. 2024; 14(16):7287. https://doi.org/10.3390/app14167287
Chicago/Turabian StyleHanczyk, Edyta, Dawid Piecuch, Szymon Kopcial, and Joanna Jonska-Gmyrek. 2024. "Factors Affecting the Effectiveness of DIBH (Deep Inspiratory Breath Hold) in Patients with Left Breast Cancer: A Narrative Review" Applied Sciences 14, no. 16: 7287. https://doi.org/10.3390/app14167287