Publication: Impact of chest wall motion caused by respiration in adjuvant radiotherapy for postoperative breast cancer patients
Issued Date
2016
Resource Type
Language
eng
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Mahidol University
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Springer
Bibliographic Citation
SpringerPlus. Vol.5, (2016), 144
Suggested Citation
C. Lowanichkiattikul, M. Dhanachai, C. Sitathanee, S. Khachonkham, P. Khaothong Impact of chest wall motion caused by respiration in adjuvant radiotherapy for postoperative breast cancer patients. SpringerPlus. Vol.5, (2016), 144. doi:10.1186/s40064-016-1831-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/3228
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Title
Impact of chest wall motion caused by respiration in adjuvant radiotherapy for postoperative breast cancer patients
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Abstract
To determine the chest wall movement of each patient during deep inspiratory
breath hold (DIBH) and expiratory breath hold (EBH) in postoperative breast cancer
patients. Postoperative breast cancer patients who underwent CT simulation for 3D
radiotherapy treatment planning during December 2012 to November 2013 were
included. Before scanning the radio-opaque wire was placed on the surface for breast
and chest wall visualization on CT images, then the patient underwent three phases of
CT scanning (free breathing, DIBH, and EBH, respectively). The distances of chest wall
motion at five reference points were calculated using the treatment planning system.
38 breast cancer patients who underwent surgery were included. Median age was 48.5
(28–85) years. Median BMI was 23.4 (16.6–38.3) kg/m2. Median lung volume was 3160.5
(1830.8–4754.0) cm3. Median Haller index was 2.43 (1.92–3.56). Median chest wall
movement was wider in anteroposterior (A–P, 4.2–5.4 mm) than superoinferior (S–I,
2.5–2.6 mm) and mediolateral (M–L, 0.6–1.1 mm) dimension in all five measured points.
There was no significant effect of the type of surgery, BMI, lung volume, and the Haller
index on the distances of chest wall movement. Additional margins of 7, 5, and 2 mm
to the A–P, S–I, and M–L dimension should adequately cover the extreme chest wall
movement in 95 % of the patients. This study showed that the maximal movement of
the chest wall during DIBH and EBH was greatest in the A–P axis followed by the S–I
axis, while the M–L axis was minimally affected by respiration.