Breast cancer: new technology to reduce the risk of heart disease after treatment
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Breast cancer: new technology to reduce the risk of heart disease after treatment

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June 07, 2022

13:07

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UZ Brussel uses a new, more precise radiation technique to reduce the risk of heart damage in patients with breast cancer. The first results are promising.

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This is encouraging news. Since last February, the UZ Brussel has been using a new technology aimed at reducing the risk of heart disease linked to radiotherapy during breast cancer, the “Deep Inspiration Breath Hold” (DIBH ExacTrac Dynamic) or “inspiration procedure blocked”. Verdict: the results on the first 25 patients are already promisingannounces the hospital – the first in the world to test the technology – on Tuesday.

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30%

According to a study published by the EBCTCG group in 2017, mortality from cardiac events was increased by 30% ten years after radiotherapy for breast cancer.

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While radiation therapy is needed to reduce the risk of breast cancer recurrence, some side effects, such as risk of heart disease, can occur. During treatment, the rays can indeed cause heart damage in women. Hence the importance of modulating their intensity and precision.

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In 2017, the EBCTCG group (Early Breast Cancer Trialists’ Collaborative Group) showed through a study that the incidence of heart failure was multiplied by 1.94 ten years after radiotherapy for breast cancer. The mortality by heart attack was she, increased by 30%. Other analyzes also revealed that the risk was especially present in patients with a tumor in the left breast.

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Precision

Designed by German company Brainlabthe system ExacTrac Dynamic used by UZ Brussel allows a more precise irradiation of the tumor by detecting possible variations in the patient’s position and rectifying them immediately, if necessary, but also by constantly monitoring the depth of breathing.

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How Brainlab’s ExacTrac Dynamic System Works

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To achieve this, ExacTrac Dynamic combines two technologies: thermal surface monitoring and monitoring by radiography.

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  • The 4D thermal camerawhich, thanks to 300,000 control points, locates the external anatomical surface of the patient, and deduces its exact position.
  • Advanced X-Ray Monitoringwhich, thanks to the high resolution images it provides, prevents blur effects due to movements.

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“When a patient inhales deeply, the distance between the heart and the breast increases, which reduces radiation to the heart and therefore the risk of heart damage.”

Pr. Mark The Knight

Head of the radiotherapy department at UZ Brussel

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Controlled breathing

Concretely, it not only makes it possible to know that the heart is not located in the field of treatment, but also to reduce the impact on the tissues around the tumor, thanks to a better measurement of patient breathing.

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“The radiation to the heart can be reduced by treating patients during a deep inspiration, explains Professor Mark De Ridder, head of the radiotherapy department. When a patient inhales deeply, the distance between heart and breast increases, which reduces radiation to the heart and therefore the risk of heart damage.”

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In this blocked inspiration procedure (DIBH), patients are treated for approximately five 25-second breathing pauses, he says again. They can follow their breathing live on a screen and adjust it by inhaling more or less deeply.

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Technology ExacTrac Dynamic was also installed at ASZ Aalst, where radiotherapy is provided by UZ Brussel. Studies are currently being conducted to see how it can also improve the treatment of lung cancer.

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