Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials

Background: Adjuvant radiotherapy (RT) of left sided breast cancer is increasingly performed in deep inspiration breath hold (DIBH). This technique requires active involvement and compliance of patients as well as pulmonary endurance. Since previous studies focused on female patients with a median a...

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Main Authors: Rebecca Moser, Lena Marie Buchecker, Jantje M. Bohlen, Mathias Düsberg, Maximilian Aigner, Nina A. Mayr, Jana Nano, Sophie T. Behzadi, Sophia Kiesl, Marciana-Nona Duma, Markus Oechsner, Stephanie E. Combs, Kai J. Borm
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405630825000461
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author Rebecca Moser
Lena Marie Buchecker
Jantje M. Bohlen
Mathias Düsberg
Maximilian Aigner
Nina A. Mayr
Jana Nano
Sophie T. Behzadi
Sophia Kiesl
Marciana-Nona Duma
Markus Oechsner
Stephanie E. Combs
Kai J. Borm
author_facet Rebecca Moser
Lena Marie Buchecker
Jantje M. Bohlen
Mathias Düsberg
Maximilian Aigner
Nina A. Mayr
Jana Nano
Sophie T. Behzadi
Sophia Kiesl
Marciana-Nona Duma
Markus Oechsner
Stephanie E. Combs
Kai J. Borm
author_sort Rebecca Moser
collection DOAJ
description Background: Adjuvant radiotherapy (RT) of left sided breast cancer is increasingly performed in deep inspiration breath hold (DIBH). This technique requires active involvement and compliance of patients as well as pulmonary endurance. Since previous studies focused on female patients with a median age under 65 years to test practicability of DIBH and advantages in comparison to free breathing (FB), DIBH in elderly patients over 65 years remains mostly underexplored. This study aims to evaluate attitudes and feasibility of DIBH in elderly breast cancer patients. Methods: First a 14-item survey of 100 female breast cancer patients aged ≥65 years was conducted to assess their attitudes toward DIBH and their breath-hold capability. Secondly, we performed a matched-pair analyses using pooled data from the prospective GATTUM and B-REST trials to compare respiratory and dosimetric parameters during DIBH between patients aged ≥65 years (n = 30) and <65 years (n = 30). Results: According to the survey large majority of patients were interested in DIBH: 98 % stated that age should not be a criterion when selecting patients for DIBH, and 66 were able to hold their breath > 20 s. Based on the matched-pair analyses of the GATTUM and B-Rest trials, no significant differences were observed regarding breath hold amplitude, duration and stability, and in DIBH-induced dose reduction to organs at risk between elderly (≥65) (n = 30) and younger patients (n = 30). Conclusion: Based on our results age alone should not be used as a criterion for excluding patients from DIBH in the treatment of left-sided breast cancer.
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spelling doaj-art-fa4fd2c30a4748cf8636bcd1b30ccba72025-08-20T02:10:02ZengElsevierClinical and Translational Radiation Oncology2405-63082025-07-015310095610.1016/j.ctro.2025.100956Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trialsRebecca Moser0Lena Marie Buchecker1Jantje M. Bohlen2Mathias Düsberg3Maximilian Aigner4Nina A. Mayr5Jana Nano6Sophie T. Behzadi7Sophia Kiesl8Marciana-Nona Duma9Markus Oechsner10Stephanie E. Combs11Kai J. Borm12Department of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyInstitute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764 Oberschleißheim, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Department of Radiation Oncology, Helios Clinics of Schwerin-University Campus of MSH Medical School Hamburg, Schwerin, Germany; Department for Human Medicine, MSH Medical School Hamburg, Hamburg, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; German Consortium for Translational Cancer Research (dktk), Partner Site Munich, Germany; School of Human Medicine, Michigan State University, East Lansing, MI, USADepartment of Radiation Oncology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Corresponding author at: Department of Radiation Oncology, TUM School of Medicine and Health, Ismaninger Straße 22, 81675 Munich, Germany.Background: Adjuvant radiotherapy (RT) of left sided breast cancer is increasingly performed in deep inspiration breath hold (DIBH). This technique requires active involvement and compliance of patients as well as pulmonary endurance. Since previous studies focused on female patients with a median age under 65 years to test practicability of DIBH and advantages in comparison to free breathing (FB), DIBH in elderly patients over 65 years remains mostly underexplored. This study aims to evaluate attitudes and feasibility of DIBH in elderly breast cancer patients. Methods: First a 14-item survey of 100 female breast cancer patients aged ≥65 years was conducted to assess their attitudes toward DIBH and their breath-hold capability. Secondly, we performed a matched-pair analyses using pooled data from the prospective GATTUM and B-REST trials to compare respiratory and dosimetric parameters during DIBH between patients aged ≥65 years (n = 30) and <65 years (n = 30). Results: According to the survey large majority of patients were interested in DIBH: 98 % stated that age should not be a criterion when selecting patients for DIBH, and 66 were able to hold their breath > 20 s. Based on the matched-pair analyses of the GATTUM and B-Rest trials, no significant differences were observed regarding breath hold amplitude, duration and stability, and in DIBH-induced dose reduction to organs at risk between elderly (≥65) (n = 30) and younger patients (n = 30). Conclusion: Based on our results age alone should not be used as a criterion for excluding patients from DIBH in the treatment of left-sided breast cancer.http://www.sciencedirect.com/science/article/pii/S2405630825000461RadiotherapyDeep inspiration breath holdFree breathingBreast cancer
spellingShingle Rebecca Moser
Lena Marie Buchecker
Jantje M. Bohlen
Mathias Düsberg
Maximilian Aigner
Nina A. Mayr
Jana Nano
Sophie T. Behzadi
Sophia Kiesl
Marciana-Nona Duma
Markus Oechsner
Stephanie E. Combs
Kai J. Borm
Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials
Clinical and Translational Radiation Oncology
Radiotherapy
Deep inspiration breath hold
Free breathing
Breast cancer
title Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials
title_full Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials
title_fullStr Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials
title_full_unstemmed Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials
title_short Assessment of the impact of age on DIBH in radiotherapy based on the prospective GATTUM and B-REST trials
title_sort assessment of the impact of age on dibh in radiotherapy based on the prospective gattum and b rest trials
topic Radiotherapy
Deep inspiration breath hold
Free breathing
Breast cancer
url http://www.sciencedirect.com/science/article/pii/S2405630825000461
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