A Systematic Review of Deep Inspiration Breath Hold and Free Breathing in Proton Beam Therapy Plans for Breast Cancer Radiotherapy

IF 3 3区医学 Q2 ONCOLOGY Clinical oncology Pub Date : 2025-04-01 Epub Date: 2025-02-01 DOI:10.1016/j.clon.2025.103782

F. Wilson , P. Gupta , H. Halvorsen , C. Anandadas , D. Lines , M. Aznar

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Abstract

Aims

To conduct a systematic review of breast cancer radiotherapy studies reporting a comparison of proton beam therapy (PBT) in deep inspiration breath hold (DIBH) and in free breathing (FB).

Methods and materials

Studies comparing DIBH and FB proton beam therapy plans, in the same patient, published between 2015 and 2023 were included. Doses to organs at risk were compared between DIBH and FB plans.

Results

Nine papers were identified for inclusion, reporting on 97 patients in total. All plans were for left-sided treatment. Average weighted mean heart dose was 0.31 Gy for DIBH and 0.48 Gy for FB. Average weighted mean left lung dose was 5.27 Gy for DIBH and 4.80 Gy for FB. Average weighted mean near maximum/maximum left anterior descending artery dose was 6.49 Gy for DIBH and 8.74 Gy for FB.

Conclusion

Based on the current literature, it does not appear that DIBH offers a marked dosimetric benefit to most breast cancer patients treated with PBT. However, the benefits of combining PBT and DIBH for individual breast RT patients cannot be excluded.

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深吸气屏气和自由呼吸在乳癌放疗质子束治疗方案中的系统评价

目的对质子束治疗（PBT）在深度吸气屏气（DIBH）和自由呼吸（FB）下的乳腺癌放疗研究进行系统回顾。方法和材料纳入2015年至2023年间发表的对同一患者进行DIBH和FB质子束治疗方案比较的研究。比较了DIBH和FB两种方案对危险器官的剂量。结果纳入9篇文献，共报道97例患者。所有方案均为左侧治疗。DIBH的心脏平均加权剂量为0.31 Gy， FB为0.48 Gy。DIBH的平均加权平均左肺剂量为5.27 Gy， FB为4.80 Gy。平均加权平均近最大/最大左前降支剂量DIBH为6.49 Gy， FB为8.74 Gy。结论根据目前的文献，DIBH对大多数接受PBT治疗的乳腺癌患者似乎没有明显的剂量学益处。然而，不能排除PBT和DIBH联合治疗个体乳房RT患者的益处。

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来源期刊

Clinical oncology 医学-肿瘤学

CiteScore

5.20

自引率

8.80%

发文量

332

审稿时长

40 days

期刊介绍： Clinical Oncology is an International cancer journal covering all aspects of the clinical management of cancer patients, reflecting a multidisciplinary approach to therapy. Papers, editorials and reviews are published on all types of malignant disease embracing, pathology, diagnosis and treatment, including radiotherapy, chemotherapy, surgery, combined modality treatment and palliative care. Research and review papers covering epidemiology, radiobiology, radiation physics, tumour biology, and immunology are also published, together with letters to the editor, case reports and book reviews.