The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.

<h4>Background</h4>Left-sided post-mastectomy radiotherapy (PMRT) certainly precedes some radiation dose to the cardiopulmonary organs causing many side effects. To reduce the cardiopulmonary dose, we created a new option of the breathing adapted technique by using abdominal compression...

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Autores principales:	Chalardchay Pratoomchart, Pitchayaponne Klunklin, Somsak Wanwilairat, Wannapha Nobnop, Kittikun Kittidachanan, Imjai Chitapanarux
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7b9cc3f5b92b4b299e686445345fc48a
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spelling	oai:doaj.org-article:7b9cc3f5b92b4b299e686445345fc48a2021-12-02T20:09:08ZThe advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.1932-620310.1371/journal.pone.0254934https://doaj.org/article/7b9cc3f5b92b4b299e686445345fc48a2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254934https://doaj.org/toc/1932-6203<h4>Background</h4>Left-sided post-mastectomy radiotherapy (PMRT) certainly precedes some radiation dose to the cardiopulmonary organs causing many side effects. To reduce the cardiopulmonary dose, we created a new option of the breathing adapted technique by using abdominal compression applied with a patient in deep inspiration phase utilizing shallow breathing. This study aimed to compare the use of abdominal compression with shallow breathing (ACSB) with the free breathing (FB) technique in the left-sided PMRT.<h4>Materials and methods</h4>Twenty left-sided breast cancer patients scheduled for PMRT were enrolled. CT simulation was performed with ACSB and FB technique in each patient. All treatment plans were created on a TomoTherapy planning station. The target volume and dose, cardiopulmonary organ volume and dose were analyzed. A linear correlation between cardiopulmonary organ volumes and doses were also tested.<h4>Results</h4>Regarding the target volumes and dose coverage, there were no significant differences between ACSB and FB technique. For organs at risk, using ACSB resulted in a significant decrease in mean (9.17 vs 9.81 Gy, p<0.0001) and maximum heart dose (43.79 vs 45.45 Gy, p = 0.0144) along with significant reductions in most of the evaluated volumetric parameters. LAD doses were also significantly reduced by ACSB with mean dose 19.24 vs 21.85 Gy (p = 0.0036) and the dose to 2% of the volume (D2%) 34.46 vs 37.33 Gy (p = 0.0174) for ACSB and FB technique, respectively. On the contrary, the lung dose metrics did not show any differences except the mean V5 of ipsilateral lung. The positive correlations were found between increasing the whole lung volume and mean heart dose (p = 0.05) as well as mean LAD dose (p = 0.041) reduction.<h4>Conclusions</h4>The ACSB technique significantly reduced the cardiac dose compared with the FB technique in left-sided PMRT treated by Helical TomoTherapy. Our technique is uncomplicated, well-tolerated, and can be applied in limited resource center.Chalardchay PratoomchartPitchayaponne KlunklinSomsak WanwilairatWannapha NobnopKittikun KittidachananImjai ChitapanaruxPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254934 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chalardchay Pratoomchart Pitchayaponne Klunklin Somsak Wanwilairat Wannapha Nobnop Kittikun Kittidachanan Imjai Chitapanarux The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.
description	<h4>Background</h4>Left-sided post-mastectomy radiotherapy (PMRT) certainly precedes some radiation dose to the cardiopulmonary organs causing many side effects. To reduce the cardiopulmonary dose, we created a new option of the breathing adapted technique by using abdominal compression applied with a patient in deep inspiration phase utilizing shallow breathing. This study aimed to compare the use of abdominal compression with shallow breathing (ACSB) with the free breathing (FB) technique in the left-sided PMRT.<h4>Materials and methods</h4>Twenty left-sided breast cancer patients scheduled for PMRT were enrolled. CT simulation was performed with ACSB and FB technique in each patient. All treatment plans were created on a TomoTherapy planning station. The target volume and dose, cardiopulmonary organ volume and dose were analyzed. A linear correlation between cardiopulmonary organ volumes and doses were also tested.<h4>Results</h4>Regarding the target volumes and dose coverage, there were no significant differences between ACSB and FB technique. For organs at risk, using ACSB resulted in a significant decrease in mean (9.17 vs 9.81 Gy, p<0.0001) and maximum heart dose (43.79 vs 45.45 Gy, p = 0.0144) along with significant reductions in most of the evaluated volumetric parameters. LAD doses were also significantly reduced by ACSB with mean dose 19.24 vs 21.85 Gy (p = 0.0036) and the dose to 2% of the volume (D2%) 34.46 vs 37.33 Gy (p = 0.0174) for ACSB and FB technique, respectively. On the contrary, the lung dose metrics did not show any differences except the mean V5 of ipsilateral lung. The positive correlations were found between increasing the whole lung volume and mean heart dose (p = 0.05) as well as mean LAD dose (p = 0.041) reduction.<h4>Conclusions</h4>The ACSB technique significantly reduced the cardiac dose compared with the FB technique in left-sided PMRT treated by Helical TomoTherapy. Our technique is uncomplicated, well-tolerated, and can be applied in limited resource center.
format	article
author	Chalardchay Pratoomchart Pitchayaponne Klunklin Somsak Wanwilairat Wannapha Nobnop Kittikun Kittidachanan Imjai Chitapanarux
author_facet	Chalardchay Pratoomchart Pitchayaponne Klunklin Somsak Wanwilairat Wannapha Nobnop Kittikun Kittidachanan Imjai Chitapanarux
author_sort	Chalardchay Pratoomchart
title	The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.
title_short	The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.
title_full	The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.
title_fullStr	The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.
title_full_unstemmed	The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.
title_sort	advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by helical tomotherapy.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/7b9cc3f5b92b4b299e686445345fc48a
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The advantages of abdominal compression with shallow breathing during left-sided postmastectomy radiotherapy by Helical TomoTherapy.

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