Women who have breast cancer
on their left side present a particular challenge to radiation oncologists.
Studies have shown that the risk of heart disease is higher in this group of
women after radiation treatment because it can be difficult to ensure that a
sufficient dose of radiation is delivered to the left breast while adequately
shielding the heart from exposure. New research shows a woman who holds her
breath during radiation pulses can greatly reduce radiation exposure to the
heart.
"Radiation therapy is commonly
prescribed to patients with breast cancer following surgery as a component of
first-line therapy," said first author Harriet Eldredge-Hindy, M.D., a
Chief Resident and researcher in the Department of Radiation Oncology at Thomas
Jefferson University "We wanted to determine how effective breath-hold
could be in shielding the heart from extraneous radiation exposure during
treatment of the left breast."
Recent studies have shown women
with cancer in the left breast are at higher risk of heart disease, and that
the risk increases proportionately with the dose of radiation the heart is
exposed to during treatment. A number of techniques have been developed to
reduce exposure to the heart including prone positioning (lying flat on the
belly on a bed that only exposes the left breast), intensity-modulated
radiation therapy (IMRT), and accelerated partial breast irradiation. The
breath-hold technique allows doctors to monitor a patient's breath for the
position that shifts the heart out of the range of the radiation beam.
In the largest prospective study to
date, following women for 8 years post treatment, 81 women were asked to hold
their breath during radiation treatment for breast cancer- a process that was
repeated until therapeutic dose was reached. The researchers found that
patients capable of holding their breath over the course of treatment had a 90
percent disease-free survival, and a 96 percent overall survival, with a median
reduction in radiation dose to the heart of 62 percent. The findings were
published online this week in the journal Practical Radiation Oncology.
"Given that this technique helps to shield the
heart during radiation treatment for breast cancer," said Rani Anne, M.D.,
Associate Professor of Radiation Oncology at Thomas Jefferson University and senior
author on the study, "we routinely offer breast cancer treatment with the
breath hold technique at Jefferson."
Source: EurekAlert
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