Add like
Add dislike
Add to saved papers

Alternating expiration and inspiration breath-hold spares the chest wall during stereotactic body radiotherapy for peripheral lung malignancies.

PURPOSE: The proximity of tumors to the chest wall brings additional risks of chest wall pain during stereotactic body radiotherapy (SBRT). Herein, we dosimetrically compared alternated breath-hold (ABH) plans with single BH plans, as well as to determine the common characteristics of eligible patients who may obtain better chest wall sparing using this technique.

METHODS AND MATERIALS: Twenty patients with lung lesions adjacent to the chest wall were enrolled and received respiratory training. Their half-fractions end-expiration (EEBH) and deep inspiration breath-hold (DIBH) plans were summed to generate the ABH plans. Dosimetric parameters of the chest wall were compared between single and alternated BH plans. And the correlation between tumor location and the outcome of chest wall sparing was quantitatively evaluated. Pre-treatment CBCT variations in eligible patients were recorded as well.

RESULTS: Compared to the EEBH and DIBH plans, the ABH plans reduced chest wall dosimetric results with median reductions of 2.0% and 3.9% (Dmax), 15.4% and 14.8% (D1cc), 48.8% and 63% (V30), respectively. Relative tumor displacements (SI/d value) were greater in the lower lobe than in the upper and middle lobes (1.17 vs. 0.18). Meanwhile, better median reductions of 44% (Dmax), 46% (D1cc), and 98% (V30) were obtained in the lower lobe cohort using the ABH technique. Pre-treatment variations for all BHs met the 5 mm threshold.

CONCLUSIONS: The ABH technique can significantly spare the adjacent chest wall without compromising PTV coverage in comparison with the single BH. And patients with tumors in the lower lobes can obtain better chest wall sparing than in the upper and middle lobes. Further investigation is warranted to validate these findings.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app