Defense Date
2024
Document Type
Thesis
Degree Name
Master of Science
Department
Radiation Oncology
First Advisor
Siyong Kim, PhD
Second Advisor
Lulin Yuan, PhD
Abstract
The purpose of this research is entrenched in advancing the practice of 3D Conformal Radiation Therapy (3D CRT) for breast cancer patients by meticulously evaluating the impact of different Deep Inspiration Breath Hold (DIBH) techniques on dosimetric parameters. This study aims to ascertain the quantitative benefits of varied breathing techniques, primarily focusing on the 'Ultimate DIBH' method's efficacy in sparing critical organs such as the heart and lungs.
The comprehensive analysis of different DIBH techniques in this research is not merely an academic exercise but is geared towards substantiating the hypothesized advantages of these techniques with empirical data. By generating and comparing 3D CRT plans for each patient under different respiratory conditions—free breathing, natural DIBH, and ultimate DIBH—the research seeks to methodically appraise the nuances of each technique. The core objective is to utilize dose distribution metrics and volumetric analysis as definitive gauges of treatment efficacy.
Significantly, the research incorporates a personalized approach, recognizing the diversity in patients' anatomical and physiological profiles. Tailoring DIBH protocols to individualize therapy aligns with contemporary paradigms of precision medicine. It acknowledges the unique interplay of each patient's anatomy and respiratory mechanics, thus opening avenues for maximizing the therapeutic index.
The employment of ultimate DIBH, a technique distinguished by the combined use of chest and abdominal muscles to achieve optimal thoracic expansion, is hypothesized to facilitate enhanced heart and lung sparing. The expectation, grounded in literature and preliminary data, is that the ultimate DIBH will exhibit superior organ-at-risk sparing without compromising the effective dose delivery to the target breast tissue. This would be a significant step forward in reducing the long-term sequelae of radiation therapy, such as radiation-induced heart disease and pulmonary fibrosis, which impact patient quality of life and survival.
This research, therefore, stands at the confluence of clinical application and scientific inquiry. It aims to bridge the gap between theoretical knowledge of radiation physics and the practical exigencies of patient-specific radiation therapy. By providing a meticulous comparative analysis of DIBH techniques through a personalized lens, this study aims to contribute substantively to the body of knowledge in radiation oncology and inform clinical practice, ultimately enhancing patient care in the treatment of breast cancer.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-8-2024