Dosimetric Impact of Deep Inspiration Breath Hold (DIBH) Technique in Right-Sided Breast Cancer Radiotherapy: A Retrospective Analysis


Abstract

Background and Purpose: While deep-inspiration breath hold (DIBH) is widely used to reduce cardiac dose in left-sided breast cancer radiotherapy, its dosimetric benefits for right-sided cases remain underexplored. This study evaluates DIBH’s impact on target volumes and organs at risk (OARs) in right-sided breast cancer, and investigates associations between dose-volume changes, lung volume, and anthropometric indices.

Methods: We retrospectively analyzed 33 right-sided breast cancer patients treated with DIBH. Seventeen received whole-breast (WB) irradiation post-breast-conserving surgery, and sixteen received chest wall (CW) plus internal mammary node (IMN) and supraclavicular (SC) irradiation post-mastectomy. CT scans acquired under free breathing (FB) and DIBH were used to generate separate treatment plans. We compared dose-volume parameters for target and OARs, and analyzed correlations between FB-to-DIBH changes and body mass index (BMI) and body surface area (BSA).

Results: Compared to FB, DIBH significantly reduced doses to the right lung, heart, right coronary artery (RCA), and liver (all P<0.05), while PTV D mean and contralateral lung V 5 showed no significant differences. WB patients had greater dose reductions than those receiving nodal irradiation. BMI was positively correlated with liver dose reduction (r = 0.544) and negatively with FB right-lung volume (r = −0.404); BSA showed no significant associations.

Conclusion: DIBH effectively reduces OAR doses in right-sided breast cancer radiotherapy and may improve long-term outcomes. Notably, patients with higher BMI benefit more from liver sparing, suggesting BMI-informed selection may enhance DIBH utility.

Ask to review this manuscript

Notes for potential reviewers

  • Volunteering is not a guarantee that you will be asked to review. There are many reasons: reviewers must be qualified, there should be no conflicts of interest, a minimum of two reviewers have already accepted an invitation, etc.
  • This is NOT OPEN peer review. The review is single-blind, and all recommendations are sent privately to the Academic Editor handling the manuscript. All reviews are published and reviewers can choose to sign their reviews.
  • What happens after volunteering? It may be a few days before you receive an invitation to review with further instructions. You will need to accept the invitation to then become an official referee for the manuscript. If you do not receive an invitation it is for one of many possible reasons as noted above.

  • PeerJ does not judge submissions based on subjective measures such as novelty, impact or degree of advance. Effectively, reviewers are asked to comment on whether or not the submission is scientifically and technically sound and therefore deserves to join the scientific literature. Our Peer Review criteria can be found on the "Editorial Criteria" page - reviewers are specifically asked to comment on 3 broad areas: "Basic Reporting", "Experimental Design" and "Validity of the Findings".
  • Reviewers are expected to comment in a timely, professional, and constructive manner.
  • Until the article is published, reviewers must regard all information relating to the submission as strictly confidential.
  • When submitting a review, reviewers are given the option to "sign" their review (i.e. to associate their name with their comments). Otherwise, all review comments remain anonymous.
  • All reviews of published articles are published. This includes manuscript files, peer review comments, author rebuttals and revised materials.
  • Each time a decision is made by the Academic Editor, each reviewer will receive a copy of the Decision Letter (which will include the comments of all reviewers).

If you have any questions about submitting your review, please email us at [email protected].