title: Dose-Volume Analysis of Lung and Heart according to Respiration in Breast Cancer Patients Treated with Breast Conserving Surgery.
abstract: OBJECTIVE
  Adjuvant radiotherapy of breast cancer using a photon tangential field incurs a risk of late heart and lung toxicity. The use of free breathing (FB), expiration breath hold (EBH), and deep inspiration breath hold (DIBH) during tangential breast radiotherapy as a means of reducing irradiated lung and heart volume was evaluated.
  
  
  METHODS
  In 10 women with left-sided breast cancer (mean age, 44 years) post-operative computed tomography (CT) scanning was done under different respiratory conditions using FB, EBH, and DIBH in 3 CT scans. For each scan, an optimized radiotherapy plan was designed with 6 MV photon tangential fields encompassing the clinical target volume after breast-conserving surgery.
  
  
  RESULTS
  The results of dose-volume histograms were compared using three breathing pattern techniques for the irradiated volume and dose to the heart. A significant reduction dose to the irradiated heart volume for the DIBH breathing technique was compared to FB and EBH breathing techniques (p<0.05).
  
  
  CONCLUSIONS
  This study demonstrated that the irradiated heart volume can be significantly reduced in patients with left-sided breast cancer using the DIBH breathing technique for tangential radiotherapy.
authors.affiliation: Department of Radiological Science, Hanseo University, Seosan, Korea.
authors.forename: Jae-Goo
authors.initials: JG
authors.lastname: Shim
authors.forename: Jeong-Koo
authors.initials: JK
authors.lastname: Kim
authors.forename: Won
authors.initials: W
authors.lastname: Park
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Seo
authors.forename: Chae-Sun
authors.initials: CS
authors.lastname: Hong
authors.forename: Ki-Won
authors.initials: KW
authors.lastname: Song
authors.forename: Cheong-Hwan
authors.initials: CH
authors.lastname: Lim
authors.forename: Hong-Ryang
authors.initials: HR
authors.lastname: Jung
authors.forename: Chan-Hyeong
authors.initials: CH
authors.lastname: Kim