Deepti Sharma - Dept of Radiation Oncology, ILBS, New Delhi
Nidhi Marjara - Dept of Radiation Oncology Max Superspeciality Hospital, Shalimar Bagh ,Delhi
Vineeta Goel - Department of Radiation Oncology, Fortis Superspeciality Hospital, Shalimar Bagh Delhi
Nithya Loganathan - Department of Radiation Oncology Max Superspeciality Hospital, Shalimar Bagh ,Delhi

Introduction: Long term cardiac morbidity is a concern with left sided breast/chest wall irradiation. In this present study, we have evaluated the Impact of Voluntary deep inspiratory breath hold (V-DIBH) Vs Free Breathing (FB) technique on heart and lung doses for left-sided breast cancer with audio visual guidance. Material and Methods: A total of ۳۱ patients diagnosed with left breast cancer were found to be suitable for V-DIBH. Patients were trained for breath hold technique for ۳ to      ۴ days on CT simulator. Seven  patients being non-compliant to  V-DIBH  therefore ۲۴ patients were simulated for breath hold. We made tangential IMRT plans for all the patients on both V-DIBH and free breathing scans for dosimetric comparison. D۹۵% target and organ at risk (OARs) like Dmean of heart, LAD, lung and opposite breast were compared for both plans.  Results: A significant reduction of mean cardiac dose from ۵.۷ ± ۱.۵۸ Gy to ۳.۴۵ ± ۰.۶۸ Gy (p<.۰۵) and cardiac V۲۵Gy from ۷.۲۸ ±۳.۹۷ % to ۱.۶۴ ± ۱.۳۵% (p<.۰۵) in V-DIBH cases as compared to FB. Mean dose to the LAD was reduced by ۳.۹ Gy in DIBH cases (p<.۰۵). Differences between FB and V-DIBH mean lung dose was ۲.۴۷ Gy (p=.۱۰۶, ns) and ipsilateral lung V۲۰Gy was ۲.۵۷% (p=.۰۷۸, ns). Conclusion: This study demonstrates dosimetric benefits of V-DIBH over FB in reducing dose to heart, LAD and ipsilateral lung without compromising the target volume coverage. We should opt for V-DIBH over FB for left sided breast cancer cases

V, DIBH Free Breathing Heart Lung Breast Cancer