%0 Journal Article
%T Optimizing Cardiac-Sparing Radiotherapy: Final Analysis of the SAVE-HEART Study on Surface-Guided DIBH in Left-Sided Breast Cancer
%A Suresh Ramanathan Pillai
%A Ravi Shankar Menon
%J Archive of International Journal of Cancer and Allied Science
%@ 3108-4834
%D 2023
%V 3
%N 1
%R 10.51847/ZPbOVVfhgC
%P 104-115
%X Radiotherapy (RT) is a key component in treating early-stage breast cancer (BC), but it may cause adverse effects on the heart and lungs. Deep inspiration breath hold (DIBH) has been shown to improve protection of these critical organs. In this prospective study, we investigated the use of surface-guided DIBH compared to standard free breathing (FB) in patients with left-sided BC, focusing on both individualized cardiovascular risk factors and the dosimetric characteristics of treatment plans. Between October 2016 and January 2021, a total of 585 patients with left-sided invasive breast carcinoma, eligible for adjuvant radiotherapy (RT) to the breast or thoracic wall with or without regional lymph nodes, were enrolled in the study. Patients were required to maintain a breath-hold of at least 20 seconds. Treatments were delivered either as hypofractionated (HF; 40.05 Gy in 15 fractions) or normofractionated (NF; 50.00 Gy in 25 fractions) regimens. Deep inspiration breath hold (DIBH) was implemented using the Catalyst surface-guided system, featuring audio–visual feedback. Both surface imaging data and computed tomography were acquired under DIBH and free breathing (FB) conditions. The primary objective of the study was to assess the reduction in cardiac dose achieved with DIBH compared to FB.

DIBH substantially enhanced treatment plan dosimetry. Compared with free breathing (FB), maximum and mean doses to the heart and left coronary artery were lowered by 36%–42% in both hypofractionated and normofractionated regimens (P 
%U https://smerpub.com/article/optimizing-cardiac-sparing-radiotherapy-final-analysis-of-the-save-heart-study-on-surface-guided-di-wqet7mhozhivyxw