When
using radiotherapy for left-sided breast cancer a breath-hold
technique can be used to decrease the dose in the heart. However, due
to anatomical variations in some patients, the radiation dose to the
heart remains relatively high, even with the use of advanced
photon-based techniques. In a radiotherapy planning study, in which 20
left-sided breast cancer patients were included, we noted that
intensity modulated proton therapy (IMPT), when compared to intensity
modulated radiotherapy (IMRT; i.e. photon therapy), enabled
better sparing of the heart, even without using a breath-hold
technique. In the majority of the IMPT cases, a reduction to almost
zero to the heart was obtained. However, as IMPT for breast cancer is
currently not widely available, IMPT should be reserved for patients
remaining at high risk for major coronary events.
