Dose Sparing with Breath-Holding Compared with Free Breathing in Right Sided Breast Cancer Irradiation

Elsayed, Nehal Gamal; Hassan, Doaa Abdelhady; Ahmed, Nabila Hassan; Soliman, Mohamed Ibrahim; Elwan, Amira

doi:10.30476/mejc.2026.106378.2262

Dose Sparing with Breath-Holding Compared with Free Breathing in Right Sided Breast Cancer Irradiation

Document Type : Original Article(s)

Authors

Nehal Gamal Elsayed ¹

Doaa Abdelhady Hassan ¹

Nabila Hassan Ahmed ²

Mohamed Ibrahim Soliman ³

Amira Elwan ¹

¹ Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

² Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

³ Zagazig Army Forced Oncology Center, Zagazig, Egypt

https://doi.org/10.30476/mejc.2026.106378.2262

Abstract

Background: Deep inspiration breath-hold (DIBH) technique is superior to the free breathing (FB) in irradiation of breast and chest wall. The radiation exposure of liver, lungs and heart is decreased considerably when right breast cancer (RBC) is treated with DIBH. The present study aimed to reduce the toxicity of RBC irradiation to risk organs.
Method: This prospective clinical study included 120 female patients who were randomly allocated into 2 Arms, arm A received FB, arm B received DIBH, each compromising 60cases. The comparison of both arms, treatment plans evaluation and dose volume histograms were analyzed to assess doses to clinical target volume (CTV), boost and risk organs (liver, ipsilateral lung and heart). A study of alanine transaminase (ALT) and aspartate transaminase (AST) as pre, during and 3 months post-treatment were done. Statistical Package of Social Services version 24 was used to analyze data. Statistical analysis was determined using the chi square and Mann-Whitney U test and P ≤ 0.05 was considered statistically significant.
Results: The mean, minimum and maximum doses of CTV and boost in both arms showed no significant difference. Mean, minimum and maximum doses of liver and right lung in both arms showed significant difference, doses in DIBH technique were less than FB. Mean and maximum doses of heart in both arms showed significant difference, while the minimum dose of heart did not. Pre-, during, and 3 months post-treatment ALT and AST values showed no significant difference.
Conclusion: In RBC patients DIBH is an efficient method for lowering liver, ipsilateral lung and heart radiation exposure.

Highlights

Nabila Hassan Ahmed (google scholar)

Amira Elwan (google scholar)

Keywords

Breast neoplasms

Deep inspiration breath hold

Radiotherapy

Dose reduction

Subjects

Cancer Treatment

How to cite this article:

Elsayed NG, Hassan DA, Ahmed NH, Soliman MI, Elwan A. Dose sparing with breath-holding compared with free breathing in right sided breast cancer irradiation. Middle East J Cancer. 2026; 17(3): 250-9. doi: 10.30476/mejc.2026. 106378.2262.

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