title: Advantage of deep inspiration breath hold in left-sided breast cancer patients treated with 3D conformal radiotherapy.
abstract: OBJECTIVE
  To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB.
  
  
  METHODS
  Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans. Dose to PTV was 50 Gy in 25 fractions. Two treatment plans were generated for each patient: FB-3D-CRT and DIBH-3D-CRT. Dosimetry parameters were obtained from dose volume histograms. Data were compared using the paired-sample Wilcoxon signed rank test.
  
  
  RESULTS
  For heart, LADCA, and left lung, a significant dose reduction was found using DIBH technique. By using DIBH, an average reduction of 25% was observed in LADCA for the volume receiving 20 Gy and of 48% considering the mean heart dose.
  
  
  CONCLUSIONS
  The DIBH technique results in a significant decrease of dose to the heart, LADCA, and left lung compared to FB.
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Luciana
authors.initials: L
authors.lastname: Lastrucci
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Borghesi
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Bertocci
authors.affiliation:  Health Physics Unit, San Donato Hospital, Arezzo - Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Gasperi
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rampini
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Buonfrate
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pernici
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: De Majo
authors.affiliation:  Unit of Radiation Oncology, San Donato Hospital, Arezzo - Italy.
authors.forename: Pietro Giovanni
authors.initials: PG
authors.lastname: Gennari
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D062485:Breath Holding; D005260:Female; D006801:Humans; D020266:Radiotherapy, Conformal / Q000379:methods*