Dosimetric benefits of deep inspiration breath-hold in postoperative radiotherapy for left-sided breast cancer after breast-conserving surgery: an anatomical parameter-based analysis
- 1Department of Radiation Oncology, Xingtai People’s Hospital
Abstract
Objective: To investigate the dosimetric impact of deep inspiration breath-hold (DIBH) technique on radiotherapy after breast-conserving surgery for left-sided breast cancer, and to explore the relationship between patient anatomical characteristics and dosimetric benefits of DIBH, providing preliminary evidence for understanding individual differences in DIBH related dosimetric gains and their personalized application.
Methods: This retrospective study included 17 patients who underwent postoperative radiotherapy after breast-conserving surgery for left-sided breast cancer. All patients underwent computed tomography (CT) simulation under both DIBH and free-breathing (FB) conditions, and intensity-modulated radiation therapy (IMRT) plans were generated from both image sets. With identical prescription doses and planning optimization objectives, dosimetric parameters for the left lung, heart, and cardiac substructures were compared between the two respiratory conditions. Correlations of the maximum cardiac margin distance (MCMD), cardiac displacement, cardiac displacement volume, heart-to-breast distance (HBD), and changes in lung volume with dosimetric parameters were also analyzed.
Results: Compared with FB, DIBH significantly reduced the mean dose (Dmean), V20, and V30 of the left lung, as well as the cardiac Dmean, V20, V30, and V40 (all P < 0.05). In addition, DIBH significantly reduced the mean doses to of the right ventricle (RV), left ventricle (LV), and left anterior descending coronary artery (LAD) compared with FB (all P < 0.05). Correlation analysis demonstrated that MCMD under the DIBH condition was positively correlated with cardiac Dmean. The change in MCMD between DIBH and FB was negatively correlated with cardiac and ventricular dose parameters. Cardiac displacement volume between the two respiratory states was positively correlated with changes in mean heart dose. Further analysis revealed that changes in lung volume were positively correlated with cardiac displacement along the Z-axis and changes in HBD while negatively correlated with LAD Dmean under the DIBH condition.
Conclusion: DIBH can reduce radiation exposure to the left lung, heart, and selected cardiac substructures while satisfying target-dose requirements. Exploratory analyses indicated that cardiac geometric parameters and changes in lung volume were associated with selected dosimetric parameters, suggesting that dynamic anatomical changes during DIBH may help explain interindividual differences in dosimetric benefit. These findings require further validation in larger, multicenter cohorts.
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BibTeX
@article{cui2026dosimetric,
title = {{Dosimetric benefits of deep inspiration breath-hold in postoperative radiotherapy for left-sided breast cancer after breast-conserving surgery: an anatomical parameter-based analysis}},
author = {Yanli Cui and Shuai Xu and Xiaozhen Wang and Liwei Huo and Jintao Wen and Lixia Hao and Xiaotong Wang and Qin Zhang and Honghong Duan},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1917416},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1917416/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Dosimetric benefits of deep inspiration breath-hold in postoperative radiotherapy for left-sided breast cancer after breast-conserving surgery: an anatomical parameter-based analysis
AU - Yanli Cui
AU - Shuai Xu
AU - Xiaozhen Wang
AU - Liwei Huo
AU - Jintao Wen
AU - Lixia Hao
AU - Xiaotong Wang
AU - Qin Zhang
AU - Honghong Duan
PY - 2026
DA - 2026/10/19
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1917416
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1917416/full
AB - Objective: To investigate the dosimetric impact of deep inspiration breath-hold (DIBH) technique on radiotherapy after breast-conserving surgery for left-sided breast cancer, and to explore the relationship between patient anatomical characteristics and dosimetric benefits of DIBH, providing preliminary evidence for understanding individual differences in DIBH related dosimetric gains and their personalized application. Methods: This retrospective study included 17 patients who underwent postoperative radiotherapy after breast-conserving surgery for left-sided breast cancer. All patients underwent computed tomography (CT) simulation under both DIBH and free-breathing (FB) conditions, and intensity-modulated radiation therapy (IMRT) plans were generated from both image sets. With identical prescription doses and planning optimization objectives, dosimetric parameters for the left lung, heart, and cardiac substructures were compared between the two respiratory conditions. Correlations of the maximum cardiac margin distance (MCMD), cardiac displacement, cardiac displacement volume, heart-to-breast distance (HBD), and changes in lung volume with dosimetric parameters were also analyzed. Results: Compared with FB, DIBH significantly reduced the mean dose (Dmean), V20, and V30 of the left lung, as well as the cardiac Dmean, V20, V30, and V40 (all P < 0.05). In addition, DIBH significantly reduced the mean doses to of the right ventricle (RV), left ventricle (LV), and left anterior descending coronary artery (LAD) compared with FB (all P < 0.05). Correlation analysis demonstrated that MCMD under the DIBH condition was positively correlated with cardiac Dmean. The change in MCMD between DIBH and FB was negatively correlated with cardiac and ventricular dose parameters. Cardiac displacement volume between the two respiratory states was positively correlated with changes in mean heart dose. Further analysis revealed that changes in lung volume were positively correlated with cardiac displacement along the Z-axis and changes in HBD while negatively correlated with LAD Dmean under the DIBH condition. Conclusion: DIBH can reduce radiation exposure to the left lung, heart, and selected cardiac substructures while satisfying target-dose requirements. Exploratory analyses indicated that cardiac geometric parameters and changes in lung volume were associated with selected dosimetric parameters, suggesting that dynamic anatomical changes during DIBH may help explain interindividual differences in dosimetric benefit. These findings require further validation in larger, multicenter cohorts.
SN - 2234-943X
ER -