The UK HeartSpare Study (Stage II): Multicentre Evaluation of a Voluntary Breath-hold Technique in Patients Receiving Breast Radiotherapy

Bartlett, FR, Donovan, Ellen, McNair, HA, Corsini, LA, Colgan, RM, Evans, Philip, Maynard, L, Griffin, C, Haviland, JS, Yarnold, JR et al and Kirby, AM (2016) The UK HeartSpare Study (Stage II): Multicentre Evaluation of a Voluntary Breath-hold Technique in Patients Receiving Breast Radiotherapy Clinical Oncology, 29 (3). e51-e56.

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Abstract

Aims To evaluate the feasibility and heart-sparing ability of the voluntary breath-hold (VBH) technique in a multicentre setting. Materials and methods Patients were recruited from 10 UK centres. Following surgery for early left breast cancer, patients with any heart inside the 50% isodose from a standard free-breathing tangential field treatment plan underwent a second planning computed tomography (CT) scan using the VBH technique. A separate treatment plan was prepared on the VBH CT scan and used for treatment. The mean heart, left anterior descending coronary artery (LAD) and lung doses were calculated. Daily electronic portal imaging (EPI) was carried out and scanning/treatment times were recorded. The primary end point was the percentage of patients achieving a reduction in mean heart dose with VBH. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. Results In total, 101 patients were recruited during 2014. Primary end point data were available for 93 patients, 88 (95%) of whom achieved a reduction in mean heart dose with VBH. Mean cardiac doses (Gy) for free-breathing and VBH techniques, respectively, were: heart 1.8 and 1.1, LAD 12.1 and 5.4, maximum LAD 35.4 and 24.1 (all P<0.001). Population EPI-based displacement data showed Σ =+1.3–1.9 mm and σ=1.4–1.8 mm. Median CT and treatment session times were 21 and 22 min, respectively. Conclusions The VBH technique is confirmed as effective in sparing heart tissue and is feasible in a multicentre setting.

Item Type:	Article
Subjects :	Electronic Engineering
Divisions :	Faculty of Engineering and Physical Sciences > Electronic Engineering
Authors :	Name Email ORCID Bartlett, FR Donovan, Ellen e.donovan@surrey.ac.uk McNair, HA Corsini, LA Colgan, RM Evans, Philip p.evans@surrey.ac.uk Maynard, L Griffin, C Haviland, JS Yarnold, JR Kirby, AM
Date :	24 November 2016
Funders :	NIHR
DOI :	10.1016/j.clon.2016.11.005
Grant Title :	Research for patient benefit
Copyright Disclaimer :	© 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords :	Breast cancer, breath-hold, cardiac dose, heart-sparing breast radiotherapy, radiotherapy
Related URLs :	Publisher
Depositing User :	Symplectic Elements
Date Deposited :	09 Feb 2017 12:30
Last Modified :	11 Dec 2018 11:22
URI:	http://epubs.surrey.ac.uk/id/eprint/813496

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