deep inspiration breath hold reduces dose to the left ventricle and proximal left anterior descending artery during radiotherapy for left-sided breast cancers深吸气呼吸减少剂量的左心室和左冠状动脉前降近端在左侧乳腺癌放射治疗.pdfVIP

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deep inspiration breath hold reduces dose to the left ventricle and proximal left anterior descending artery during radiotherapy for left-sided breast cancers深吸气呼吸减少剂量的左心室和左冠状动脉前降近端在左侧乳腺癌放射治疗.pdf

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deep inspiration breath hold reduces dose to the left ventricle and proximal left anterior descending artery during radiotherapy for left-sided breast cancers深吸气呼吸减少剂量的左心室和左冠状动脉前降近端在左侧乳腺癌放射治疗

Journal of Cancer Therapy, 2012, 3, 673-679 673 /10.4236/jct.2012.325087 Published Online October 2012 (http://www.SciRP.org/journal/jct) Deep Inspiration Breath Hold Reduces Dose to the Left Ventricle and Proximal Left Anterior Descending Artery during Radiotherapy for Left-Sided Breast Cancers 1 2 2* Lesley A. Jarvis , Peter G. Maxim , Kathleen C. Horst 1Department of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, USA; 2Department of Radiation Oncology, Stanford University Medical Center, Stanford, USA. * Email: kateh@ Received June 20th, 2012; revised July 23rd, 2012; accepted August 4th, 2012 ABSTRACT The purpose of this study was to analyze motion of the left anterior descending coronary artery (LAD) and left ventricle during normal breathing and deep inspiration breath hold (DIBH). This is a dosimetric study utilizing free-breathing and static DIBH scans from eleven patients treated with radiotherapy for breast cancer. The anterior-posterior displacement along the length of the LAD was measured in each respiratory phase. Standard treatment plans targeting the whole breast without treatment of the internal mammary lymph nodes were generated and dose to the LAD and LV calculated. Non-uniform movement of the LAD during respiratory maneuvers with the proximal third exhibiting the greatest dis- placement was observed. In DIBH compared to end-expiration (EP), the mean posterior displacement of the proximal 1/3 of the LAD was 8.99 mm, the middle 1/3 of the artery was 6.37 mm, and the distal 1/3 was 3.27 mm. In end-inspiration (IP) compared to end-expiration the mean posterior displacements of the proximal 1/3 of the LAD was 2.08 mm, the middle 1/3 of