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Dosimetric impact of deep inspiration breath hold (DIBH) technique in right-sided breast cancer radiotherapy: a retrospective analysis.

PeerJ 2026 Vol.14() p. e20993

Jiang L, Su Z, Jing Z, Sun C, Wu Z

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[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

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APA Jiang L, Su Z, et al. (2026). Dosimetric impact of deep inspiration breath hold (DIBH) technique in right-sided breast cancer radiotherapy: a retrospective analysis.. PeerJ, 14, e20993. https://doi.org/10.7717/peerj.20993
MLA Jiang L, et al.. "Dosimetric impact of deep inspiration breath hold (DIBH) technique in right-sided breast cancer radiotherapy: a retrospective analysis.." PeerJ, vol. 14, 2026, pp. e20993.
PMID 41907456
DOI 10.7717/peerj.20993

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 evaluated DIBH's impact on target coverage and organs at risk (OARs) in right-sided breast cancer, and investigated associations between dose-volume changes, lung volume, and anthropometric indices.

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

[RESULTS] Compared with FB, DIBH significantly reduced doses to the right lung, heart, right coronary artery (RCA), and liver in both cohorts (all  < 0.05), while planning target volume (PTV) coverage remained unchanged. The maximum dose to the contralateral breast (Dmax) also decreased under DIBH, with reductions of 22.7% in the WB group ( = 0.02) and 37.76% in the CW+IMN+SC group ( < 0.001). Body mass index (BMI) showed a significant association with DIBH induced liver dose reduction in the WB cohort (liver mean dose, Dmean:  = 0.622,  = 0.008; liver volume receiving > =5Gy, V5Gy:  = 0.483,  = 0.05). In contrast, no meaningful correlations with dosimetric parameters were observed for BSA (all  > 0.05).

[CONCLUSION] DIBH effectively reduced OAR doses in right-sided breast cancer radiotherapy while maintaining target coverage. Patients with higher BMI derived greater hepatic dose sparing, suggesting that BMI-informed patient selection may enhance the clinical utility of DIBH.

MeSH Terms

Humans; Retrospective Studies; Female; Breath Holding; Middle Aged; Unilateral Breast Neoplasms; Radiotherapy Dosage; Organs at Risk; Aged; Adult; Radiotherapy Planning, Computer-Assisted; Heart; Lung; Breast Neoplasms; Inhalation; Tomography, X-Ray Computed

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