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The UK HeartSpare study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy

The UK HeartSpare study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy
The UK HeartSpare study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy
Purpose: to determine whether voluntary deep-inspiratory breath-hold (v_DIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABC_DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery.

Methods: following surgery for early breast cancer, patients underwent planning-CT scans in v_DIBH and ABC_DIBH. Patients were randomised to receive one technique for fractions 1–7 and the second technique for fractions 8–15 (40?Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (?) and random errors (?) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test.

Results: twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived ? were ?1.8?mm (v_DIBH) and ?2.0?mm (ABC_DIBH) and ? ?2.5?mm (v_DIBH) and ?2.2?mm (ABC_DIBH) (all p non-significant). CBCT-derived ? were ?3.9?mm (v_DIBH) and ?4.9?mm (ABC_DIBH) and ? ??4.1?mm (v_DIBH) and ??3.8?mm (ABC_DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v_DIBH (p?=?0.007, p?=?0.03, respectively). Scanning/treatment setup times were shorter for v_DIBH (p?=?0.02, p?=?0.04, respectively).

Conclusions: v_DIBH and ABC_DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v_DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC_DIBH
0167-8140
242-247
Bartlett, F.R.
f976e273-95ca-405b-9152-d1b603c491cb
Colgan, R.M.
c4e7d8e0-2411-458f-8427-2da9a1cb39aa
Carr, K.
95e767b0-c4d6-431e-be20-6addd027a82d
Donovan, E.M.
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McNair, H.A.
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Locke, I.
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Evans, P.M.
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Haviland, J.S.
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Yarnold, J.R.
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Kirby, A.M.
553f52fa-b7a1-4d97-8b0b-dffbd35a6b33
Bartlett, F.R.
f976e273-95ca-405b-9152-d1b603c491cb
Colgan, R.M.
c4e7d8e0-2411-458f-8427-2da9a1cb39aa
Carr, K.
95e767b0-c4d6-431e-be20-6addd027a82d
Donovan, E.M.
2f2248fe-7d3f-436f-8814-25fdd7936242
McNair, H.A.
a8a9c6f8-874d-41b8-9413-af96dfd6e54e
Locke, I.
0e6925ba-d9b0-46e1-b868-3387a3aecbee
Evans, P.M.
59193ce5-2b34-4e1f-b586-21451818051f
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Yarnold, J.R.
0e51cc2f-3eb1-464f-bf61-d2ac2e86e958
Kirby, A.M.
553f52fa-b7a1-4d97-8b0b-dffbd35a6b33

Bartlett, F.R., Colgan, R.M., Carr, K., Donovan, E.M., McNair, H.A., Locke, I., Evans, P.M., Haviland, J.S., Yarnold, J.R. and Kirby, A.M. (2013) The UK HeartSpare study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy. Radiotherapy and Oncology, 108 (2), 242-247. (doi:10.1016/j.radonc.2013.04.021).

Record type: Article

Abstract

Purpose: to determine whether voluntary deep-inspiratory breath-hold (v_DIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABC_DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery.

Methods: following surgery for early breast cancer, patients underwent planning-CT scans in v_DIBH and ABC_DIBH. Patients were randomised to receive one technique for fractions 1–7 and the second technique for fractions 8–15 (40?Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (?) and random errors (?) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test.

Results: twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived ? were ?1.8?mm (v_DIBH) and ?2.0?mm (ABC_DIBH) and ? ?2.5?mm (v_DIBH) and ?2.2?mm (ABC_DIBH) (all p non-significant). CBCT-derived ? were ?3.9?mm (v_DIBH) and ?4.9?mm (ABC_DIBH) and ? ??4.1?mm (v_DIBH) and ??3.8?mm (ABC_DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v_DIBH (p?=?0.007, p?=?0.03, respectively). Scanning/treatment setup times were shorter for v_DIBH (p?=?0.02, p?=?0.04, respectively).

Conclusions: v_DIBH and ABC_DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v_DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC_DIBH

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Published date: 2013
Organisations: Faculty of Health Sciences

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Local EPrints ID: 365657
URI: https://eprints.soton.ac.uk/id/eprint/365657
ISSN: 0167-8140
PURE UUID: f8c5b6a1-6d82-451d-af9c-e62b983d9cc6

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Date deposited: 16 Jun 2014 10:41
Last modified: 18 Jul 2017 02:19

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Contributors

Author: F.R. Bartlett
Author: R.M. Colgan
Author: K. Carr
Author: E.M. Donovan
Author: H.A. McNair
Author: I. Locke
Author: P.M. Evans
Author: J.S. Haviland
Author: J.R. Yarnold
Author: A.M. Kirby

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