{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:16:40Z","timestamp":1774257400775,"version":"3.50.1"},"reference-count":32,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Chinese Academy of Sciences Hangzhou Institute of Medicine","award":["No. 2024ZZBS20"],"award-info":[{"award-number":["No. 2024ZZBS20"]}]},{"name":"Central guidance for local scientific and technological development funding project","award":["No. 2025ZY01106"],"award-info":[{"award-number":["No. 2025ZY01106"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background and Purpose<\/jats:title>\n While deep-inspiration breath hold (DIBH) is widely used to reduce cardiac dose in left-sided breast cancer radiotherapy, its dosimetric benefits for right-sided cases remain underexplored. This study evaluated DIBH\u2019s impact on target coverage and organs at risk (OARs) in right-sided breast cancer, and investigated associations between dose-volume changes, lung volume, and anthropometric indices.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed 33 patients with right-sided breast cancer treated using DIBH. Seventeen patients received whole-breast (WB) irradiation following post\u2013breast-conserving surgery, and sixteen received chest wall (CW) plus internal mammary node (IMN) and supraclavicular (SC) irradiation post-mastectomy. Computed tomography (CT) scans acquired under free breathing (FB) and DIBH were used to generate separate treatment plans. Dose-volume parameters for target volumes and OARs were compared, and correlations between FB-to-DIBH changes and body mass index (BMI) and body surface area (BSA) were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared with FB, DIBH significantly reduced doses to the right lung, heart, right coronary artery (RCA), and liver in both cohorts (all\n P<\/jats:italic>\n \u00a0<\u00a00.05), while planning target volume (PTV) coverage remained unchanged. The maximum dose to the contralateral breast (Dmax) also decreased under DIBH, with reductions of 22.7% in the WB group (\n P<\/jats:italic>\n \u00a0=\u00a00.02) and 37.76% in the CW+IMN+SC group (\n P<\/jats:italic>\n \u00a0<\u00a00.001). Body mass index (BMI) showed a significant association with DIBH induced liver dose reduction in the WB cohort (liver mean dose, Dmean:\n r<\/jats:italic>\n \u00a0=\u00a00.622,\n P<\/jats:italic>\n \u00a0=\u00a00.008; liver volume receiving >\u00a0=5Gy, V5Gy:\n r<\/jats:italic>\n \u00a0=\u00a00.483,\n P<\/jats:italic>\n \u00a0=\u00a00.05). In contrast, no meaningful correlations with dosimetric parameters were observed for BSA (all\n P<\/jats:italic>\n \u00a0>\u00a00.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n DIBH effectively reduced OAR doses in right-sided breast cancer radiotherapy while maintaining target coverage. Patients with higher BMI derived greater hepatic dose sparing, suggesting that BMI-informed patient selection may enhance the clinical utility of DIBH.<\/jats:p>\n <\/jats:sec>","DOI":"10.7717\/peerj.20993","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T08:43:11Z","timestamp":1774255391000},"page":"e20993","source":"Crossref","is-referenced-by-count":0,"title":["Dosimetric impact of deep inspiration breath hold (DIBH) technique in right-sided breast cancer radiotherapy: a retrospective analysis"],"prefix":"10.7717","volume":"14","author":[{"given":"Lu","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwei","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Zhejiang Key Laboratory of Geriatrics and Geriatrics Institute of Zhejiang Province, Affiliated Zhejiang Hospital, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhibing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Zhejiang Key Laboratory of Geriatrics and Geriatrics Institute of Zhejiang Province, Affiliated Zhejiang Hospital, Hangzhou, Zhejiang Province, China"},{"name":"Department of Oncology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"issue":"17","key":"10.7717\/peerj.20993\/ref-1","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1093\/jnci\/djr242","article-title":"Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis","volume":"103","author":"Amir","year":"2011","journal-title":"Journal of the National Cancer Institute"},{"issue":"4","key":"10.7717\/peerj.20993\/ref-2","doi-asserted-by":"publisher","first-page":"717","DOI":"10.5603\/rpor.a2022.0085","article-title":"Deep inspiration breath hold in post-operative radiotherapy for right breast cancer: a retrospective analysis","volume":"27","author":"Borgonovo","year":"2022","journal-title":"Reports of Practical Oncology and 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Onkologie"},{"key":"10.7717\/peerj.20993\/ref-29","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA: A Cancer Journal for Clinicians"},{"issue":"4","key":"10.7717\/peerj.20993\/ref-30","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1056\/nejmoa1415340","article-title":"Regional nodal irradiation in early-stage breast cancer","volume":"373","author":"Whelan","year":"2015","journal-title":"New England Journal of Medicine"},{"issue":"4","key":"10.7717\/peerj.20993\/ref-31","doi-asserted-by":"publisher","first-page":"530","DOI":"10.2478\/raon-2023-0053","article-title":"Correlation between maximum heart distance and thoracic diameter changes and diaphragmatic descent in left-sided breast cancer patients during deep inspiration breath-hold 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