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Safety of modern breast RT for lungs and heart
- Modern Radiation therapy with IMRT/IGRT is much safer
- Small risk of cardiac ds (5-6% risk at 20 years) especially for left breast cancers
- Pneumonitis <2%
Are there radiation techniques for better heart sparing?
- Partial Breast Radiation
- Prone Treatment
- Use of respiratory gating- 4D RT
Gated Breast Radiation Therapy- 4D RT
- Gating refers to 4D RT- synchronizes RT with breathing cycle
- Pts are coached to take deep breath and then hold that level of inspiration during every radiation treatment
- BH can increase distance between heart and target volume
- Beam on only during breath hold in deep Inspiration
- Its associated with lower radiation exposure to heart without compromising coverage of disease
Basic premise of BH
- DIBH involves patient inspiring to a specific threshold and then holding that level of inspiration during every RT field
- BH increases distance between heart/LAD and target volume- Heart gets pulled posteriorly, inferiorly and medially
- Lung Volume increases
