Breathing Technique Reduces Radiation Risk to the Heart

A new study shows that women who hold their breath during breast radiation therapy (RT) pulses can greatly reduce incidental doses to the heart and lung.

Researchers at Thomas Jefferson University (Philadelphia, PA, USA) conducted a study involving 112 patients with left breast cancer (LBC) to examine if active breathing coordination (ABC) can reduce the mean heart dose (MHD) incidental radiation. Median prescription dose was 50.4 Gray, and the primary endpoint of the study was magnitude of MHD reduction when comparing ABC to free breathing (FB). Secondary endpoints included dose reduction to the heart and lung, procedural success rate, and adverse events.

The results showed that RT with ABC provided a statistically significant dose reduction to the left lung and the heart by allowing doctors to monitor a patient's breath for the position that shifts the heart out of the range of the radiation beam. At eight years post-treatment, the 81 women who were capable of holding their breath over the course of treatment had a 90% disease-free and a 96% overall survival, with a reduction in MHD radiation of 62%. The findings were published on January 5, 2015, in Practical Radiation Oncology.

“ABC was well tolerated and significantly reduced MHD while preserving local control. Use of the ABC device during RT should be considered to reduce the risk of ischemic heart disease in populations at risk,” concluded senior author associate professor of radiation Oncology Rani Anne, MD, and colleagues. “Given that this technique helps to shield the heart during radiation treatment, we routinely offer breast cancer treatment with the breath hold technique at Jefferson.”

A number of different techniques have been developed to reduce exposure to the heart, including prone positioning (i.e., lying flat on the belly on a bed that only exposes the left breast), intensity-modulated radiation therapy (IMRT), and accelerated partial breast irradiation. The breath-hold technique allows doctors to monitor a patient's breath for the position that shifts the heart out of the range of the radiation beam.

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