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The UK HeartSpare Study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy

Bartlett, FR, Carr, K, McNair, HA, Locke, I, Yarnold, JR, Kirby, AM, Colgan, RM, Donovan, EM, Evans, PM and Haviland, JS (2013) The UK HeartSpare Study: Randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy Radiotherapy and Oncology, 108 (2). pp. 242-247.

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Abstract

Purpose To determine whether voluntary deep-inspiratory breath-hold (v-DIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABC-DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery. Methods Following surgery for early breast cancer, patients underwent planning-CT scans in v-DIBH and ABC-DIBH. Patients were randomised to receive one technique for fractions 1-7 and the second technique for fractions 8-15 (40 Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (Σ) and random errors (σ) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test. Results Twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived Σ were ≤1.8 mm (v-DIBH) and ≤2.0 mm (ABC-DIBH) and σ ≤2.5 mm (v-DIBH) and ≤2.2 mm (ABC-DIBH) (all p non-significant). CBCT-derived Σ were ≤3.9 mm (v-DIBH) and ≤4.9 mm (ABC-DIBH) and σ ≤ 4.1 mm (v-DIBH) and ≤ 3.8 mm (ABC-DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v-DIBH (p = 0.007, p = 0.03, respectively). Scanning/treatment setup times were shorter for v-DIBH (p = 0.02, p = 0.04, respectively). Conclusions v-DIBH and ABC-DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v-DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC-DIBH. © 2013 Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Divisions : Faculty of Engineering and Physical Sciences > Electronic Engineering > Centre for Vision Speech and Signal Processing
Authors :
AuthorsEmailORCID
Bartlett, FRUNSPECIFIEDUNSPECIFIED
Carr, KUNSPECIFIEDUNSPECIFIED
McNair, HAUNSPECIFIEDUNSPECIFIED
Locke, IUNSPECIFIEDUNSPECIFIED
Yarnold, JRUNSPECIFIEDUNSPECIFIED
Kirby, AMUNSPECIFIEDUNSPECIFIED
Colgan, RMUNSPECIFIEDUNSPECIFIED
Donovan, EMUNSPECIFIEDUNSPECIFIED
Evans, PMUNSPECIFIEDUNSPECIFIED
Haviland, JSUNSPECIFIEDUNSPECIFIED
Date : August 2013
Identification Number : 10.1016/j.radonc.2013.04.021
Additional Information : NOTICE: this is the author’s version of a work that was accepted for publication in Radiotherapy and Oncology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Radiotherapy and Oncology, 108(2), August 2013, DOI 10.1016/j.radonc.2013.04.021.
Depositing User : Symplectic Elements
Date Deposited : 17 Dec 2014 14:17
Last Modified : 20 Dec 2014 14:33
URI: http://epubs.surrey.ac.uk/id/eprint/806912

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