Abstract
Introduction
One of the most feared side effects of radiotherapy (RT) in the setting of breast cancer (BC) patients is cardiac toxicity. This side effect can jeopardize the quality of life (QoL) of long-term survivors. The impact of modern techniques of RT such as deep inspiration breath hold (DIBH) have dramatically changed this setting. We report and discuss the results of the literature overview of this paper.
Materials and methods
Literature references were obtained with a PubMed query, hand searching, and clinicaltrials.gov.
Results
We reported and discussed the toxicity of RT and the improvements due to the modern techniques in the setting of BC patients.
Conclusions
BC patients often have a long life expectancy, thus the RT should aim at limiting toxicities and at the same time maintaining the same high cure rates. Further studies are needed to evaluate the risk–benefit ratio to identify patients at higher risk and to tailor the treatment choices.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Al-Rahbi ZS, Al Mandhari Z, Ravichandran R et al (2013) Dosimetric comparison of intensity modulated radiotherapy isocentric field plans and field in field (FIF) forward plans in the treatment of breast cancer. J Med Phys 38(1):22–29. https://doi.org/10.4103/0971-6203.106601
Bartlett FR, Colgan RM, Carr K, Donovan EM, McNair HA, Locke I et al (2013) The UK HeartSpare Study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy. Radiother Oncol 108(2):242–247. https://doi.org/10.1016/j.radonc.2013.04.021 (Epub 2013/06/04 PubMed PMID: 23726115)
Bartlett FR, Colgan RM, Donovan EM, Carr K, Landeg S, Clements N et al (2014) Voluntary breath-hold technique for reducing heart dose in left breast radiotherapy. J vis Exp: Jove 89:51578. https://doi.org/10.3791/51578 (PubMed PMID: 25046661)
Beadle BM, Woodward WA, Tucker SL, Outlaw ED, Allen PK, Oh JL et al (2009) Ten-year recurrence rates in young women with breast cancer by locoregional treatment approach. Int J Radiat Oncol Biol Phys 73(3):734–744. https://doi.org/10.1016/j.ijrobp.2008.04.078 (Epub 2008/08/19 PubMed PMID: 18707822; PubMed Central PMCID: PMCPmc3041273)
Beckham WA, Popescu CC, Patenaude VV, Wai ES, Olivotto IA (2007) Is multibeam IMRT better than standard treatment for patients with left-sided breast cancer? Int J Radiat Oncol Biol Phys 69(3):918–924. https://doi.org/10.1016/j.ijrobp.2007.06.060 (PubMed PMID: 17889273)
Boda-Heggemann J, Knopf AC, Simeonova-Chergou A, Wertz H, Stieler F, Jahnke A et al (2016) Deep inspiration breath hold-based radiation therapy: a clinical review. Int J Radiat Oncol Biol Phys 94(3):478–492. https://doi.org/10.1016/j.ijrobp.2015.11.049 (Epub 2016/02/13 PubMed PMID: 26867877)
Bolukbasi Y, Saglam Y, Selek U, Topkan E, Kataria A, Unal Z et al (2014) Reproducible deep-inspiration breath-hold irradiation with forward intensity-modulated radiotherapy for left-sided breast cancer significantly reduces cardiac radiation exposure compared to inverse intensity-modulated radiotherapy. Tumori 100(2):169–178. https://doi.org/10.1700/1491.16405 (Epub 2014/05/24PubMed PMID: 24852861)
Chen MH, Chuang ML, Bornstein BA, Gelman R, Harris JR, Manning WJ (1997) Impact of respiratory maneuvers on cardiac volume within left-breast radiation portals. Circulation 96(10):3269–3272. https://doi.org/10.1161/01.cir.96.10.3269 (Epub 1997/12/13 PubMed PMID: 9396414)
Clarke MJ (2008) WITHDRAWN: Radiotherapy for early breast cancer. Cochrane Database Syst Rev (4):CD003647. https://doi.org/10.1002/14651858.CD003647.pub2
Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106. https://doi.org/10.1016/s0140-6736(05)67887-7 (Epub 2005/12/20 PubMed PMID: 16360786)
Comsa D, Barnett E, Le K, Mohamoud G, Zaremski D, Fenkell L et al (2014) Introduction of moderate deep inspiration breath hold for radiation therapy of left breast: Initial experience of a regional cancer center. Pract Radiat Oncol 4(5):298–305. https://doi.org/10.1016/j.prro.2013.10.006 (Epub 2014/09/07 PubMed PMID: 25194098)
Correa CR, Litt HI, Hwang WT, Ferrari VA, Solin LJ, Harris EE (2007) Coronary artery findings after left-sided compared with right-sided radiation treatment for early-stage breast cancer. J Clin Oncol 25(21):3031–3037. https://doi.org/10.1200/jco.2006.08.6595 (Epub 2007/07/20 PubMed PMID: 17634481)
Cuzick J, Stewart H, Peto R, Baum M, Fisher B, Host H et al (1987) Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer. Cancer Treat Rep 71(1):15–29 (Epub 1987/01/01 PubMed PMID: 2856861)
Darby SC, Cutter DJ, Boerma M, Constine LS, Fajardo LF, Kodama K et al (2010) Radiation-related heart disease: current knowledge and future prospects. Int J Radiat Oncol Biol Phys 76(3):656–665. https://doi.org/10.1016/j.ijrobp.2009.09.064 (PubMed PMID: 20159360)
Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Brønnum D et al (2013) Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 368(11):987–998. https://doi.org/10.1056/NEJMoa1209825 (Epub 2013/03/15 PubMed PMID: 23484825)
Dell’Oro M, Giles E, Sharkey A, Borg M, Connell C, Bezak E (2019) A Retrospective dosimetric study of radiotherapy patients with left-sided breast cancer; patient selection criteria for deep inspiration breath hold technique. Cancers (basel) 11(2):259. https://doi.org/10.3390/cancers11020259 (PubMed PMID: 30813346)
Duma MN, Molls M, Trott KR (2014) From heart to heart for breast cancer patients - cardiovascular toxicities in breast cancer radiotherapy. Strahlenther Onkol 190(1):5–7. https://doi.org/10.1007/s00066-013-0465-4 (Epub 2013/11/21 PubMed PMID: 24253182)
Eldredge-Hindy H, Lockamy V, Crawford A, Nettleton V, Werner-Wasik M, Siglin J et al (2015) Active Breathing Coordinator reduces radiation dose to the heart and preserves local control in patients with left breast cancer: report of a prospective trial. Pract Radiat Oncol 5(1):4–10. https://doi.org/10.1016/j.prro.2014.06.004 (Epub 2015/01/09 PubMed PMID: 25567159; PubMed Central PMCID: PMCPmc4289538)
Feng M, Moran JM, Koelling T et al (2011) Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer. Int J Radiat Oncol Biol Phys 79(1):10–18. https://doi.org/10.1016/j.ijrobp.2009.10.058
Francolini G, Desideri I, Meattini I, Becherini C, Terziani F, Olmetto E et al (2019) Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy: quality assessment within a randomized phase III trial testing a cardioprotective treatment strategy (SAFE-2014). Strahlenther Onkol 195(1):43–51. https://doi.org/10.1007/s00066-018-1388-x (Epub 2018/11/09 PubMed PMID: 30406290)
Guarneri V, Conte PF (2004) The curability of breast cancer and the treatment of advanced disease. Eur J Nucl Med Mol Imaging 31(Suppl 1):S149–S161. https://doi.org/10.1007/s00259-004-1538-5 (Epub 2004/04/27 PubMed PMID: 15107948)
Hardenbergh PH, Munley MT, Bentel GC, Kedem R, Borges-Neto S, Hollis D et al (2001) Cardiac perfusion changes in patients treated for breast cancer with radiation therapy and doxorubicin: preliminary results. Int J Radiat Oncol Biol Phys 49(4):1023–1028. https://doi.org/10.1016/s0360-3016(00)01531-5 (Epub 2001/03/10 PubMed PMID: 11240243)
Haubner F, Ohmann E, Pohl F, Prantl L, Strutz J, Gassner HG (2013) Effects of radiation on the expression of adhesion molecules and cytokines in a static model of human dermal microvascular endothelial cells. Clin Hemorheol Microcirc 54(4):371–379. https://doi.org/10.3233/ch-2012-1626 (Epub 2012/10/24 PubMed PMID: 23089880)
Heidenreich PA, Hancock SL, Lee BK, Mariscal CS, Schnittger I (2003) Asymptomatic cardiac disease following mediastinal irradiation. J Am Coll Cardiol 42(4):743–749. https://doi.org/10.1016/s0735-1097(03)00759-9 (Epub 2003/08/23 PubMed PMID: 12932613)
Hjelstuen MH, Mjaaland I, Vikström J, Dybvik KI (2012) Radiation during deep inspiration allows loco-regional treatment of left breast and axillary-, supraclavicular- and internal mammary lymph nodes without compromising target coverage or dose restrictions to organs at risk. Acta Oncol 51(3):333–344. https://doi.org/10.3109/0284186x.2011.618510 (Epub 2011/12/17 PubMed PMID: 22171587)
Hong JC, Rahimy E, Gross CP, Shafman T, Hu X, Yu JB et al (2018) Radiation dose and cardiac risk in breast cancer treatment: an analysis of modern radiation therapy including community settings. Pract Radiat Oncol 8(3):e79–e86. https://doi.org/10.1016/j.prro.2017.07.005 (Epub 2017/09/11 PubMed PMID: 28888675)
Hooning MJ, Aleman BM, van Rosmalen AJ, Kuenen MA, Klijn JG, van Leeuwen FE (2006) Cause-specific mortality in long-term survivors of breast cancer: a 25-year follow-up study. Int J Radiat Oncol Biol Phys 64(4):1081–1091. https://doi.org/10.1016/j.ijrobp.2005.10.022 (Epub 2006/02/01 PubMed PMID: 16446057)
Joo JH, Kim SS, Ahn SD, Kwak J, Jeong C, Ahn SH et al (2015) Cardiac dose reduction during tangential breast irradiation using deep inspiration breath hold: a dose comparison study based on deformable image registration. Radiat Oncol 10:264. https://doi.org/10.1186/s13014-015-0573-7 (Epub 2015/12/31 PubMed PMID: 26715382; PubMed Central PMCID: PMCPmc4696108)
Kanapuru B, Ershler WB, Hesdorffer C, Jemal A, Yates JW (2012) Long-term survival of older breast cancer patients: population-based estimates over three decades. Breast Cancer Res Treat 134(2):853–857. https://doi.org/10.1007/s10549-012-2115-4 (Epub 2012/06/20 PubMed PMID: 22710707)
Kong FM, Klein EE, Bradley JD, Mansur DB, Taylor ME, Perez CA et al (2002) The impact of central lung distance, maximal heart distance, and radiation technique on the volumetric dose of the lung and heart for intact breast radiation. Int J Radiat Oncol Biol Phys 54(3):963–971. https://doi.org/10.1016/s0360-3016(02)03741-0 (Epub 2002/10/16 PubMed PMID: 12377351)
Korreman SS, Pedersen AN, Nøttrup TJ, Specht L, Nyström H (2005) Breathing adapted radiotherapy for breast cancer: comparison of free breathing gating with the breath-hold technique. Radiother Oncol 76(3):311–318. https://doi.org/10.1016/j.radonc.2005.07.009 (Epub 2005/09/13 PubMed PMID: 16153728)
Kunheri B, Kotne S, Nair SS, Makuny D (2017) A dosimetric analysis of cardiac dose with or without active breath coordinator moderate deep inspiratory breath hold in left sided breast cancer radiotherapy. J Cancer Res Ther 13(1):56–61. https://doi.org/10.4103/jcrt.JCRT_1414_16 (Epub 2017/05/17 PubMed PMID: 28508834)
Lawler G, Leech M (2017) Dose sparing potential of deep inspiration breath-hold technique for left breast cancer radiotherapy organs-at-risk. Anticancer Res 37(2):883–890. https://doi.org/10.21873/anticanres.11394 (Epub 2017/02/10 PubMed PMID: 28179347)
Lee MS, Finch W, Mahmud E (2013) Cardiovascular complications of radiotherapy. Am J Cardiol 112(10):1688–1696. https://doi.org/10.1016/j.amjcard.2013.07.031 (Epub 2013/09/10 PubMed PMID: 24012026)
Li JG, Williams SS, Goffinet DR, Boyer AL, Xing L (2000) Breast-conserving radiation therapy using combined electron and intensity-modulated radiotherapy technique. Radiother Oncol 56(1):65–71. https://doi.org/10.1016/s0167-8140(00)00189-4 (Epub 2000/06/28 PubMed PMID: 10869757)
Linthout N, Bral S, Van de Vondel I, Verellen D, Tournel K, Gevaert T et al (2009) Treatment delivery time optimization of respiratory gated radiation therapy by application of audio-visual feedback. Radiother Oncol 91(3):330–335. https://doi.org/10.1016/j.radonc.2009.03.019 (Epub 2009/04/17 PubMed PMID: 19368987)
Lu HM, Cash E, Chen MH, Chin L, Manning WJ, Harris J et al (2000) Reduction of cardiac volume in left-breast treatment fields by respiratory maneuvers: a CT study. Int J Radiat Oncol Biol Phys 47(4):895–904. https://doi.org/10.1016/s0360-3016(00)00512-5 (Epub 2000/06/23PubMed PMID: 10863057)
Maity A, Kao GD, Muschel RJ, McKenna WG (1997) Potential molecular targets for manipulating the radiation response. Int J Radiat Oncol Biol Phys 37(3):639–653. https://doi.org/10.1016/s0360-3016(96)00598-6 (Epub 1997/02/01 PubMed PMID: 9112463)
McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M et al (2014) Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 383(9935):2127–2135. https://doi.org/10.1016/s0140-6736(14)60488-8 (Epub 2014/03/25 PubMed PMID: 24656685; PubMed Central PMCID: PMCPmc5015598)
Mohamad O, Shiao J, Zhao B, Roach K, Ramirez E, Vo DT et al (2017) Deep inspiration breathhold for left-sided breast cancer patients with unfavorable cardiac anatomy requiring internal mammary nodal irradiation. Pract Radiat Oncol 7(6):e361–e367. https://doi.org/10.1016/j.prro.2017.04.006 (Epub 2017/07/02 PubMed PMID: 28666899)
Mulliez T, Veldeman L, Speleers B, Mahjoubi K, Remouchamps V, Van Greveling A et al (2015) Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation. Radiother Oncol 114(1):79–84. https://doi.org/10.1016/j.radonc.2014.11.038 (Epub 2014/12/17 PubMed PMID: 25497557)
Ong DS, Aertker RA, Clark AN, Kiefer T, Hughes GC, Harrison JK et al (2013) Radiation-associated valvular heart disease. J Heart Valve Dis 22(6):883–892 (Epub 2014/03/07 PubMed PMID: 24597417)
Osman SO, Hol S, Poortmans PM, Essers M (2014) Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation. Radiother Oncol 112(1):17–22. https://doi.org/10.1016/j.radonc.2014.04.004 (Epub 2014/05/16 PubMed PMID: 24825176)
Pallotta S, Marrazzo L, Ceroti M, Silli P, Bucciolini M (2012) A phantom evaluation of Sentinel(™), a commercial laser/camera surface imaging system for patient setup verification in radiotherapy. Med Phys 39(2):706–712. https://doi.org/10.1118/1.3675973 (Epub 2012/02/11 PubMed PMID: 22320780)
Pedersen AN, Korreman S, Nyström H, Specht L (2004) Breathing adapted radiotherapy of breast cancer: reduction of cardiac and pulmonary doses using voluntary inspiration breath-hold. Radiother Oncol 72(1):53–60. https://doi.org/10.1016/j.radonc.2004.03.012 (Epub 2004/07/09 PubMed PMID: 15236874)
Prabhakar R, Tharmar G, Julka PK, Rath GK, Joshi RC, Bansal AK et al (2007) Impact of different breathing conditions on the dose to surrounding normal structures in tangential field breast radiotherapy. Journal of Medical Physics 32(1):24–28. https://doi.org/10.4103/0971-6203.31146 (PubMed PMID: 21217915)
Rana S (2013) Intensity modulated radiation therapy versus volumetric intensity modulated arc therapy. J Medicalradiat Sci 60:81–83
Remouchamps VM, Vicini FA, Sharpe MB, Kestin LL, Martinez AA, Wong JW (2003) Significant reductions in heart and lung doses using deep inspiration breath hold with active breathing control and intensity-modulated radiation therapy for patients treated with locoregional breast irradiation. Int J Radiat Oncol Biol Phys 55(2):392–406. https://doi.org/10.1016/s0360-3016(02)04143-3 (Epub 2003/01/16 PubMed PMID: 12527053)
Rochet N, Drake JI, Harrington K, Wolfgang JA, Napolitano B, Sadek BT et al (2015) Deep inspiration breath-hold technique in left-sided breast cancer radiation therapy: Evaluating cardiac contact distance as a predictor of cardiac exposure for patient selection. Pract Radiat Oncol 5(3):e127–e134. https://doi.org/10.1016/j.prro.2014.08.003 (Epub 2014/11/22 PubMed PMID: 25413399)
Rong Y, Walston S, Welliver MX, Chakravarti A, Quick AM (2014) Improving intra-fractional target position accuracy using a 3D surface surrogate for left breast irradiation using the respiratory-gated deep-inspiration breath-hold technique. Plos one 9(5):e97933. https://doi.org/10.1371/journal.pone.0097933 (Epub 2014/05/24. PubMed PMID: 24853144; PubMed Central PMCID: PMCPmc4031138)
Rudat V, Alaradi AA, Mohamed A, Ai-Yahya K, Altuwaijri S (2011) Tangential beam IMRT versus tangential beam 3D-CRT of the chest wall in postmastectomy breast cancer patients: a dosimetric comparison. Radiat Oncol 6:26. https://doi.org/10.1186/1748-717X-6-26 (PubMed PMID: 21418616)
Sakka M, Kunzelmann L, Metzger M, Grabenbauer GG (2017) Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation: Is IMRT more beneficial than VMAT? Strahlenther Onkol 193(10):800–811. https://doi.org/10.1007/s00066-017-1167-0 (English. Epub 2017 Jun 23 PMID: 28646251)
Schönecker S, Heinz C, Söhn M, Haimerl W, Corradini S, Pazos M et al (2016) Reduction of cardiac and coronary artery doses in irradiation of left-sided breast cancer during inspiration breath hold: a planning study. Strahlenther Onkol 192(11):750–758. https://doi.org/10.1007/s00066-016-1039-z (Epub 2016/10/27 PubMed PMID: 27632341)
Selvaraj RN, Beriwal S, Pourarian RJ, Lalonde RJ, Chen A, Mehta K et al (2007) Clinical implementation of tangential field intensity modulated radiation therapy (IMRT) using sliding window technique and dosimetric comparison with 3D conformal therapy (3DCRT) in breast cancer. Med Dosim 32(4):299–304. https://doi.org/10.1016/j.meddos.2007.03.001 (Epub 2007/11/06 PubMed PMID: 17980832)
Shah C, Badiyan S, Berry S, Khan AJ, Goyal S, Schulte K et al (2014) Cardiac dose sparing and avoidance techniques in breast cancer radiotherapy. Radiother Oncol 112(1):9–16. https://doi.org/10.1016/j.radonc.2014.04.009 (Epub 2014/05/13 PubMed PMID: 24813095)
Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67(1):7–30. https://doi.org/10.3322/caac.21387 (Epub 2017/01/06 PubMed PMID: 28055103)
Sixel KE, Aznar MC, Ung YC (2001) Deep inspiration breath hold to reduce irradiated heart volume in breast cancer patients. Int J Radiat Oncol Biol Phys 49(1):199–204. https://doi.org/10.1016/s0360-3016(00)01455-3 (Epub 2001/02/13 PubMed PMID: 11163515)
Smyth LM, Knight KA, Aarons YK, Wasiak J (2015) The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review. J Med Radiat Sci 62(1):66–73. https://doi.org/10.1002/jmrs.89 (Epub 2015/08/01. PubMed PMID: 26229669; PubMed Central PMCID: PMCPmc4364808)
Swamy ST, Radha CA, Kathirvel M et al (2014) Feasibility study of deep inspiration breath-hold based volumetric modulated arc therapy for locally advanced left sided breast cancer patients. Asian PacJ Cancer Prev 15:9033–9038
Tang X, Zagar TM, Bair E, Jones EL, Fried D, Zhang L et al (2014) Clinical experience with 3-dimensional surface matching-based deep inspiration breath hold for left-sided breast cancer radiation therapy. Pract Radiat Oncol 4(3):e151–e158. https://doi.org/10.1016/j.prro.2013.05.004 (Epub 2014/04/29 PubMed PMID: 24766689)
Tanguturi SK, Lyatskaya Y, Chen Y, Catalano PJ, Chen MH, Yeo WP et al (2015) Prospective assessment of deep inspiration breath-hold using 3-dimensional surface tracking for irradiation of left-sided breast cancer. Pract Radiat Oncol 5(6):358–365. https://doi.org/10.1016/j.prro.2015.06.002 (Epub 2015/08/02 PubMed PMID: 26231594)
Taunk NK, Haffty BG, Kostis JB, Goyal S (2015) Radiation-induced heart disease: pathologic abnormalities and putative mechanisms. Front Oncol. https://doi.org/10.3389/fonc.2015.00039
Taylor CW, Nisbet A, McGale P, Goldman U, Darby SC, Hall P et al (2009a) Cardiac doses from Swedish breast cancer radiotherapy since the 1950s. Radiother Oncol 90(1):127–135. https://doi.org/10.1016/j.radonc.2008.09.029 (Epub 2008/11/15 PubMed PMID: 19008005)
Taylor CW, McGale P, Povall JM, Thomas E, Kumar S, Dodwell D et al (2009b) Estimating cardiac exposure from breast cancer radiotherapy in clinical practice. Int J Radiat Oncol Biol Phys 73(4):1061–1068. https://doi.org/10.1016/j.ijrobp.2008.05.066 (Epub 2008/11/01 PubMed PMID: 18973978)
Veinot JP, Edwards WD (1996) Pathology of radiation-induced heart disease: a surgical and autopsy study of 27 cases. Hum Pathol 27(8):766–773. https://doi.org/10.1016/s0046-8177(96)90447-5 (Epub 1996/08/01. PubMed PMID: 8760008)
Verhoeven K, Sweldens C, Petillion S, Laenen A, Peeters S, Janssen H et al (2014) Breathing adapted radiation therapy in comparison with prone position to reduce the doses to the heart, left anterior descending coronary artery, and contralateral breast in whole breast radiation therapy. Pract Radiat Oncol 4(2):123–129. https://doi.org/10.1016/j.prro.2013.07.005 (Epub 2014/06/04 PubMed PMID: 24890353)
Vuong W, Garg R, Bourgeois DJ, Yu S, Sehgal V, Daroui P (2019) Dosimetric comparison of deep-inspiration breath-hold and free-breathing treatment delivery techniques for left-sided breast cancer using 3D surface tracking. Med Dosim 44(3):193–198. https://doi.org/10.1016/j.meddos.2018.06.002 (Epub 2018/08/07 PubMed PMID: 30078605)
Walston S, Quick AM, Kuhn K, Rong Y (2017) Dosimetric considerations in respiratory-gated deep inspiration breath-hold for left breast irradiation. Technol Cancer Res Treat 16(1):22–32. https://doi.org/10.1177/1533034615624311 (Epub 07/08 PubMed PMID: 26755749)
Wiant D, Wentworth S, Liu H, Sintay B (2015) How important is a reproducible breath hold for deep inspiration breath hold breast radiation therapy? Int J Radiat Oncol Biol Phys 93(4):901–907. https://doi.org/10.1016/j.ijrobp.2015.06.010 (Epub 2015/11/05 PubMed PMID: 26530760)
Wong JW, Sharpe MB, Jaffray DA, Kini VR, Robertson JM, Stromberg JS et al (1999) The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol Biol Phys 44(4):911–919. https://doi.org/10.1016/s0360-3016(99)00056-5 (Epub 1999/07/01 PubMed PMID: 10386650)
Xie Y, Bourgeois D, Guo B, Zhang R (2020) Comparison of conventional and advanced radiotherapy techniques for left-sided breast cancer after breast conserving surgery. Med Dosim 45(4):e9–e16. https://doi.org/10.1016/j.meddos.2020.05.004 (Epub 2020 Jul 7 PMID: 32646715)
Yeboa DN, Evans SB (2016) Contemporary breast radiotherapy and cardiac toxicity. Semin Radiat Oncol 26(1):71–78. https://doi.org/10.1016/j.semradonc.2015.09.003 (Epub 2015/12/01 PubMed PMID: 26617212)
Yeung R, Conroy L, Long K, Walrath D, Li H, Smith W et al (2015) Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation. Radiat Oncol 10:200. https://doi.org/10.1186/s13014-015-0511-8 (Epub 2015/09/24 PubMed PMID: 26391237; PubMed Central PMCID: PMCPmc4578779)
Zhu Q, Kirova YM, Cao L, Arsene-Henry A, Chen J (2018) Cardiotoxicity associated with radiotherapy in breast cancer: a question-based review with current literatures. Cancer Treat Rev 68:9–15. https://doi.org/10.1016/j.ctrv.2018.03.008 (Epub 2018/05/20 PubMed PMID: 29777800)
Funding
Nothing to declare.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Salvestrini, V., Iorio, G.C., Borghetti, P. et al. The impact of modern radiotherapy on long-term cardiac sequelae in breast cancer survivor: a focus on deep inspiration breath-hold (DIBH) technique. J Cancer Res Clin Oncol 148, 409–417 (2022). https://doi.org/10.1007/s00432-021-03875-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-021-03875-1