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An effective patient training for deep inspiration breath hold technique of left-sided breast on computed tomography simulation procedure at King Chulalongkorn Memorial Hospital

  • Oonsiri, Puntiwa (Division of Radiation Oncology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society) ;
  • Wisetrinthong, Metinee (Division of Radiation Oncology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society) ;
  • Chitnok, Manatchanok (Division of Radiation Oncology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society) ;
  • Saksornchai, Kitwadee (Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University) ;
  • Suriyapee, Sivalee (Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University)
  • Received : 2019.05.22
  • Accepted : 2019.07.01
  • Published : 2019.09.30

Abstract

Purpose: To observe the effectiveness of the practical instruction sheet and the educational video for left-sided breast treatment in a patient receiving deep inspiration breath hold (DIBH) technique. Two parameters, simulation time and patient satisfaction, were assessed through the questionnaire. Methods: Two different approaches, which were the instruction sheet and educational video, were combinedly used to assist patients during DIBH procedures. The guideline was assigned at least 1 week before the simulation date. On the simulation day, patients would fill the questionnaire regarding their satisfaction with the DIBH instruction. The questionnaire was categorized into five levels: extremely satisfied to dissatisfied, sequentially. The patients were divided into four groups: not DIBH technique, DIBH without instruction materials, the DIBH with instruction sheet or educational video, and DIBH with both of instruction sheet and educational video. Results: Total number of 112 cases of left-sided breast cancer were analyzed. The simulation time during DIBH procedure significantly reduced when patients followed the instruction. There was no significant difference in simulation time on the DIBH procedures between patient compliance via instruction sheet or educational video or even following both of them. The excellent level was found at 4.6 ± 0.1 and 4.5 ± 0.1, for patients coaching via instruction sheet as well as on the educational video, respectively. Conclusion: Patient coaching before simulation could potentially reduce the lengthy time in the simulation process for DIBH technique. Practicing the DIBH technique before treatment is strongly advised.

Keywords

References

  1. Oonsiri P, Saksornchai K, Suriyapee S. Plan evaluation of intensity modulated radiation therapy and volumetric modulated arc therapy in bilateral breast irradiation with 3-isocenter technique. J Assoc Med Sci 2018;51:81-4.
  2. Stefanovski Z, Smichkoska S, Petrova D, Lazarova E.. Advantages of the technique with segmented field for tangential breast irradiation. Proceedings of the 3rd Conference on Medical Physics and Biomedical Engineering; 2013 Oct 18-19; Skopje, Macedonia. p. 75-8.
  3. Bird BR, Swain SM. Cardiac toxicity in breast cancer survivors: review of potential cardiac problems. Clin Cancer Res 2008;14:14-24. https://doi.org/10.1158/1078-0432.CCR-07-1033
  4. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005;366:2087-106. https://doi.org/10.1016/S0140-6736(05)67887-7
  5. Early Breast Cancer Trialists' Collaborative Group. Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Lancet 2000;355:1757-70. https://doi.org/10.1016/S0140-6736(00)02263-7
  6. Paszat LF, Mackillop WJ, Groome PA, Schulze K, Holowaty E. Mortality from myocardial infarction following postlumpectomy radiotherapy for breast cancer: a populationbased study in Ontario, Canada. Int J Radiat Oncol Biol Phys 1999;43:755-62. https://doi.org/10.1016/S0360-3016(98)00412-X
  7. Latty D, Stuart KE, Wang W, Ahern V. Review of deep inspiration breath-hold techniques for the treatment of breast cancer. J Med Radiat Sci. 2015;62:74-81. https://doi.org/10.1002/jmrs.96
  8. Smyth LM, Knight KA, Aarons YK, Wasiak J. The cardiac dosesparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review. J Med Radiat Sc. 2015;62:66-73. https://doi.org/10.1002/jmrs.89
  9. Mast ME, van Kempen-Harteveld L, Heijenbrok MW, et al. Leftsided breast cancer radiotherapy with and without breathhold: does IMRT reduce the cardiac dose even further? Radiother Oncol 2013;108:248-53. https://doi.org/10.1016/j.radonc.2013.07.017
  10. Swanson T, Grills IS, Ye H, et al. Six-year experience routinely using moderate deep inspiration breath-hold for the reduction of cardiac dose in left-sided breast irradiation for patients with early-stage or locally advanced breast cancer. Am J Clin Oncol 2013;36:24-30. https://doi.org/10.1097/COC.0b013e31823fe481
  11. Osman SO, Hol S, Poortmans PM, Essers M. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation. Radiother Oncol 2014;112:17-22. https://doi.org/10.1016/j.radonc.2014.04.004
  12. Remouchamps VM, Letts N, Vicini FA, et al. Initial clinical experience with moderate deep-inspiration breath hold using an active breathing control device in the treatment of patients with left-sided breast cancer using external beam radiation therapy. Int J Radiat Oncol Biol Phys 2003;56:704-15. https://doi.org/10.1016/S0360-3016(03)00010-5
  13. Remouchamps VM, Vicini FA, Sharpe MB, Kestin LL, Martinez AA, Wong JW. Significant reductions in heart and lung doses using deep inspiration breath hold with active breathing control and intensity-modulated radiation therapy for patients treated with locoregional breast irradiation. Int J Radiat Oncol Biol Phys 2003;55:392-406. https://doi.org/10.1016/S0360-3016(02)04143-3
  14. Krauss DJ, Kestin LL, Raff G, et al. MRI-based volumetric assessment of cardiac anatomy and dose reduction via active breathing control during irradiation for left-sided breast cancer. Int J Radiat Oncol Biol Phys 2005;61:1243-50. https://doi.org/10.1016/j.ijrobp.2004.10.012
  15. Zurl B, Stranzl H, Winkler P, Kapp KS. Quantitative assessment of irradiated lung volume and lung mass in breast cancer patients treated with tangential fields in combination with deep inspiration breath hold (DIBH). Strahlenther Onkol 2010;186:157-62. https://doi.org/10.1007/s00066-010-2064-y
  16. Korreman SS, Pedersen AN, Aarup LR, Nottrup TJ, Specht L, Nystrom H. Reduction of cardiac and pulmonary complication probabilities after breathing adapted radiotherapy for breast cancer. Int J Radiat Oncol Biol Phys 2006;65:1375-80. https://doi.org/10.1016/j.ijrobp.2006.03.046
  17. Bruzzaniti V, Abate A, Pinnaro P, et al. Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer. J Exp Clin Cancer Res 2013;32:88. https://doi.org/10.1186/1756-9966-32-88
  18. Nissen HD, Appelt AL. Improved heart, lung and target dose with deep inspiration breath hold in a large clinical series of breast cancer patients. Radiother Onco. 2013;106:28-32. https://doi.org/10.1016/j.radonc.2012.10.016
  19. Czeremszynska B, Drozda S, Gorzynski M, Kepka L. Selection of patients with left breast cancer for deep-inspiration breathhold radiotherapy technique: results of a prospective study. Rep Pract Oncol Radiother 2017;22:341-8. https://doi.org/10.1016/j.rpor.2017.05.002

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