RADIATION WITH DEEP INHALE
Radiotherapy has long been shown to be one of the most effective cancer treatments. However, due to the very close location of the left breast and heart, it is exposed to radiation. Therefore, to minimize the side effects of this exposure, the DIBH technique is used. Thanks to it, the radiation dose received by the patient's heart is significantly lower. And this directly contributes to reducing the potential side effects of the therapy, i.e. cardiological diseases.
During therapy, the patient takes a deep breath and holds the air. The increased lung volume during inspiration pushes the heart away from the chest wall. During this time, the left breast is irradiated. The optimal combination of both elements (respiration-radiation dose) is a key factor in the success of the procedure. The operation of the radiological accelerator is synchronized with the established respiratory phases, and irradiation is performed only when the tumor is in the exactly fixed position.
– By using the DIBH technique, the protection of the heart muscle against ionizing radiation increases. We treat over twenty people a month using this method. These are primarily breast cancer patients. It is worth recalling that two methods are used to irradiate breast cancer; on a free and deep breath. If the patient is able to stop inhaling for an appropriate period of time during the irradiation session, the DIBH technique is chosen. Many international and national studies indicate the beneficial effects of the DIBH technique in terms of myocardial protection. Of course, this requires proper practice of the procedure before the procedure to verify whether the patient is able to hold her breath at the right moment and for the right time, already during the procedure itself. – says Marcin Hetnał, MD, PhD, Head of the Radiotherapy Department of the Rydygiera Hospital and Medical Director of the Amethyst Radiotherapy Center.
A team of technicians from the Amethyst Radiotherapy Center, led by Magdalena Nalepa, is responsible for optimal preparation of patients for the procedure.
- Before starting therapy, our staff practices breath holding with patients. We check how long patients can hold their breath. This time is carefully measured and then taken into account when planning radiation treatment. Thanks to this technique, the risk of cardiac complications is minimized because when taking in air, the chest expands, moving away from the heart. This keeps the heart outside the high radiation dose area.– says Magdalena Nalepa from the Amethyst Radiotherapy Center in Krakow.
The use of this cancer treatment method at the Amethyst Radiotherapy Center is possible thanks to the use of optical systems for positioning and monitoring the patient's position (Surface Guided Radiation Therapy (SGRT). They are most often used in the treatment of breast cancer, especially the left breast, because they allow for irradiation using the deep inhalation technique, which in turn translates into a significant reduction in the therapeutic dose to the heart and minimization of cardiac complications after radiotherapy.
– The SGRT systems used at the Amethyst Radiotherapy Center are so universal that they can be used to support treatment control of virtually any anatomical area, increasing the precision and safety of treatment. If the patient moves on the treatment table, SGRT systems will stop radiation, preventing the dose from being delivered to inappropriate areas. – says the doctor. Dariusz Martynów, specialist in oncological radiation therapy at the Center.
Positioning the patient in the same way during the process of preparing the therapy plan and during the administration of subsequent radiotherapy fractions is a great challenge for the technicians who directly coordinate this process. AlignRT® increases the comfort of both the patient and the staff. The technology is non-invasive and contactless. The technician immediately sees any deviation from the assumed tolerance limits on the monitor. During radiotherapy, if the patient's position changes, AlignRT® automatically sends a signal to interrupt the radiation treatment.
The AlignRT® system used in Amethysta is installed, among others, in the 15 best oncology centers in the United States (including Mayo Clinic and Cleveland Clinic).
