• The new technique – RPM gated DIBH technique helps protect the heart during radiotherapy in left sided breast cancer patients

Kolkata : Apollo Cancer Centre Kolkata implements ‘Deep Inspiratory Breath Hold’ (DIBH) technique with the use of real-time position management (RPM) system to treat left sided breast cancer patients. This new technique will help protect the heart during radiotherapy.

Radiotherapy is an indispensable weapon in breast cancer treatment. Most breast cancer patients who are treated with curative intent need treatment with radiotherapy; usually after surgery. Radiotherapy has been shown to reduce the risk of breast cancer recurrence and improve survival. This radiotherapy becomes technically difficult while treating left sided breast cancer patients due to presence of heart on the left side of the chest.

Excess radiation dose to the heart while treating left sided breast cancer patients can increase the risk of cardiac toxicity and reduce patient’s life span due to cardiac complications. Normally ‘Deep Inspiratory Breath Hold’ (DIBH) is one such technique, which has been shown to reduce the radiation dose to the heart and thus reduce the risk of cardiac side effects. In this technique patient needs to hold their breath for few seconds after taking deep inspiration and during that time the radiotherapy is delivered.

Sharing his thoughts on the new technique, Dr Animesh Saha, Consultant Clinical Oncologist, said, “We at Apollo Cancer Centre, Kolkata, use the DIBH technique with real-time position management (RPM) system. This RPM system will help to trace respiratory movement of patients and allow setting threshold of respiratory movement for radiotherapy. Radiation beam will only be on when the patient’s breathing is within that particular threshold of respiration and the beam will be off when the respiratory movement gets above or below the set threshold. This respiratory gating using RPM system enables pushing the heart away from radiation field, precisely in a well-controlled, automated manner and thus reducing the radiation dose to heart”.

Dr Saha added, “It will be a routine procedure from now on to treat left sided breast cancer patients with RPM gated DIBH technique and we will be able to prevent radiotherapy related cardiac toxicity for left sided breast cancer patients. Successful launch of this new technique was made possible by the teamwork of physicists, technicians, engineers and clinicians, which has made it possible to implement the procedure.”

On this occasion, Dr Surinder Singh Bhatia, Director Medical Services, Eastern Region, said, “Radiotherapy is the most important part of treating breast cancer. We at Apollo Cancer Centre are always on the lookout for improving patient care by making optimum use of new techniques. Our world-renowned clinicians brings their global experience to treat patients. We recently launched the Fast Forward Therapy for breast cancer and now with this new technique, RPM gated DIBH, our patients can be rest assured that they will receive the most advanced radiotherapy techniques with the added benefits of accuracy and a successful treatment.”

This technique is widely used in developed countries like the US and UK and is available in very few centres in India. Apollo Cancer Centre Kolkata has started treating breast cancer patients with this new technique and their first patient was successfully treated with this technique under supervision of Dr Saha. Dr Saha is well versed with this technique while working as a Consultant Clinical Oncologist in UK.