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What criteria do you use to determine the utility of DIBH for breast cancer patients?

What criteria do you use to determine the utility of using DIBH for planning after free breathing and DIBH CT scans? Do you typically create a plan for both DIBH and free-breathing and compare afterwards, or use a "1 cm heart rule" on tangents?
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In what percentage of left sided breast cancers do you use DIBH for breast PMRT?

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1 Answer
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on · Updated on

For PMRT or anyone getting RNI, favor DIBH for all (irrespective of side) to reduce lung (more important as some of the patients get TDM1 and Pembro with RT) and heart dose (as long as the patient can tolerate the procedure).

For non-RNI, make a determination only for the left-sided breast based on ...

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