Reducing cardiac doses: a novel multi-leaf collimator modification technique to reduce left anterior descending coronary artery dose in patients with left-sided breast cancer

Abstract

Introduction: When irradiating the left breast, a small portion of the heart and left anterior descending coronary artery (LAD) are often included in the treatment field. Deep inspiration breath-hold (DIBH) techniques reduce dose to coronary structures, but are resource intensive and may not be tolerated by all patients. The aim of this study was to evaluate a simple multi-leaf collimator (MLC) modification technique with respect to target coverage and organ-at-risk sparing. Methods: Forty nine patients with left-sided breast cancer, planned with a simultaneous integrated boost technique were retrospectively replanned with additional shielding of the LAD. Dose to the target volumes (whole br..