ORIGINAL RESEARCH article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1503131
Impact of Heart Motion on Radiation Dose in Heart and Left Ventricular Myocardium During Breast Cancer Treatment
Provisionally accepted
Zhiqing Xiao1,2Yanqiang Wang1,2
Miao Wang1,2Han Guo1,2Xiaotong Lin1,2
Tian Lei1,2Junling Liu1,2Xiuwu Li1,2
Xiaoying Xue1,2*- 1Department of Radiotherapy, Second Hospital of Hebei Medical University, Shijiazhuang, China
- 2Hebei Medical University, Shijiazhuang, Hebei Province, China
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Objective: To investigate changes in the geometric position and dosimetry differences of the heart and left anterior descending coronary artery (LAD) during radiotherapy with deep inspiration breath-hold (DIBH) in patients with left-sided breast cancer after radical mastectomy.: A retrospective analysis was undertaken on 10 patients with left-sided breast cancer who received deep inspiratory breath-hold radiotherapy. Changes in the motion position of the heart and the LAD and dosimetric differences were compared by analyzing planning CT and cone beam CT (CBCT) images. Results: Heart volume was negatively correlated with heart V5 and Dmean, and positively correlated with V30 and Dmax. Changes in heart volume were positively correlated with the dose changes in both the heart and LAD. The lateral (X-axis) motion of the heart was positively correlated with heart V15, V20, and LAD Dmax, but negatively correlated with heart Dmax. Superior-inferior (Y-axis) motion was negatively correlated with heart V15, V20, V30, Dmean, and changes in LAD dose. Anterior-posterior (Z-axis) motion was positively correlated with changes in heart dose and with LAD V5, V15, and V20 dose changes. Owing to alterations in the centroids, the heart requires expansions of the planning margins of 1.33mm, 4.10mm, and 2.42mm in the X, Y, and Z directions, respectively, while the LAD requires expansions of 3.13mm, 1.79mm, and 5.43 mm in the corresponding directions. in the X, Y, and Z directions, respectively. The distances of the cardiac boundary boxes during different sessions showed a positive correlation with heart V5, V15, V20, V30, and Dmean and a negative correlation with LAD V5 and Dmax. Conclusions: During the implementation of DIBH radiotherapy for treatment of left-sided breast cancer, dose assessment for the heart and LAD provided by static CT planning may contain some inaccuracies. Accordingly, it is recommended to reasonably adjust the organ-at-risk external boundaries in the treatment plan to effectively control the doses received by the heart and LAD, thereby ensuring patient safety.
Keywords: breast cancer, Radiotherapy, Deep inspiration breath-hold technique, Descending coronary artery, Cardiac dose
Received: 28 Sep 2024; Accepted: 04 Jun 2025.
Copyright: © 2025 Xiao, Wang, Wang, Guo, Lin, Lei, Liu, Li and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoying Xue, Department of Radiotherapy, Second Hospital of Hebei Medical University, Shijiazhuang, China
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