title: Dosimetric evaluation of critical organs at risk in mastectomized left-sided breast cancer radiotherapy using breath-hold technique.
abstract: OBJECTIVE
  The aim of the study was to evaluate the dosimetric impact of the active breathing control-moderate deep inspiration breath-hold (ABC-mDIBH) technique on normal tissue sparing in locally advanced left-sided breast cancer radiotherapy.
  
  
  METHODS
  Twenty-seven consecutive patients with left-sided locally advanced breast cancer referred to our department for adjuvant radiotherapy were enrolled in the study. Each patient was scanned at free breathing and ABC-mDIBH for radiation treatment planning. Two separate radiotherapy treatment plans were generated with and without ABC-mDIBH to investigate the dosimetric impact of ABC-mDIBH in breast cancer radiotherapy.
  
  
  RESULTS
  Between June 2011 and February 2012, 27 consecutive patients with left-sided locally advanced breast cancer referred to our department for adjuvant radiotherapy were enrolled in the study. Dose-volume parameters of left anterior descending coronary artery, lungs, heart, contralateral breast, esophagus and spinal cord were significantly reduced with the use of ABC-mDIBH (P <0.001).
  
  
  CONCLUSIONS
  Our study revealed that the use of ABC-mDIBH in the practice of locally advanced mastectomized left-sided breast cancer radiotherapy improves normal tissue sparing with the expected potential of decreasing treatment-related morbidity and mortality. Moreover, the resultant reduction achieved with ABC in doses to the left anterior descending coronary artery, which plays a central role in cardiac perfusion, may have implications for decreasing the potential of radiation-induced cardiac morbidity and mortality.
authors.affiliation: Department of Radiation Oncology, Gulhane Military Medical Academy, Ankara, Turkey. ferhatdincoglan@gmail.com
authors.forename: Ferrat
authors.initials: F
authors.lastname: Dincoglan
authors.forename: Murat
authors.initials: M
authors.lastname: Beyzadeoglu
authors.forename: Omer
authors.initials: O
authors.lastname: Sager
authors.forename: Kaan
authors.initials: K
authors.lastname: Oysul
authors.forename: Yelda Elcim
authors.initials: YE
authors.lastname: Kahya
authors.forename: Hakan
authors.initials: H
authors.lastname: Gamsiz
authors.forename: Bora
authors.initials: B
authors.lastname: Uysal
authors.forename: Selcuk
authors.initials: S
authors.lastname: Demiral
authors.forename: Bahar
authors.initials: B
authors.lastname: Dirican
authors.forename: Serdar
authors.initials: S
authors.lastname: Surenkok
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000528:radiation effects; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D062485:Breath Holding; D003331:Coronary Vessels / Q000528:radiation effects; D019583:Dose Fractionation, Radiation; D004947:Esophagus / Q000528:radiation effects; D005260:Female; D006321:Heart / Q000528:radiation effects; D006801:Humans; D021621:Imaging, Three-Dimensional; D007103:Immobilization / Q000379:methods; D008168:Lung / Q000528:radiation effects; D008408:Mastectomy; D008875:Middle Aged; D058958:Organs at Risk / Q000528:radiation effects*; D011832:Radiation Injuries / Q000517:prevention & control*; D011874:Radiometry; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D013116:Spinal Cord / Q000528:radiation effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014421:Turkey