To evaluate the dosimetric and clinical advantages of using deep-inspiration breath-hold (DIBH) technique in hybrid solitary dynamic portal radiotherapy (hSDPRT) for left-sided chest-wall plus regional nodal irradiation and to demonstrate a simplified strategy for preclinical commissioning and calibration of DIBH-gating technique. Fifteen patients with left-sided breast cancer who underwent postmastectomy radiotherapy using hSDPRT were retrospectively evaluated. Two sets of planning-CT images were acquired for each patient, one with free/normal breathing and the other with DIBH. The hSDPRT plans were computed to deliver about 85% of the prescribed dose using static open fields and 15% of dose using a less complex solitary dynamic field. The dosimetric differences between the paired samples were compared using the Wilcoxon signed-rank test. For clinical commissioning of gated treatments, a respiratory simulator equipped with a microcontroller was programmed to simulate free-breathing and DIBH-patterns using a custom-developed android application. While both the hSDPRT plans displayed identical target coverage on both the image-sets, the DIBH technique resulted in statistically significant differences in various dose-volume metrics of heart, left-anterior-descending artery, and ipsilateral-lung structures. The hSDPRT plan with DIBH entails reduced total monitor unit (354.9 ± 13.6 MU) and breath-hold time ranging from 2.9 ± 0.3 to 13.7 ± 0.8 seconds/field, along with an acceptable impact on overall machine throughput. DIBH is a feasible method to effectively address the delivery uncertainty and produce substantial sparing of heart and lung when combined with hSDPRT. Streamlined procedures for commissioning and calibration of DIBH-gating technique are essential for more efficient clinical practice.

评估使用深吸气屏气（DIBH）技术在左侧左侧胸壁加区域性淋巴结照射的混合孤立动态门放射疗法（hSDPRT）中的剂量学和临床优势，并演示简化的临床前调试和校准策略DIBH门控技术。回顾性评估了使用hSDPRT进行乳房切除术后放疗的15例左侧乳腺癌患者。为每位患者获取了两组计划性CT图像，一组具有自由/正常呼吸，另一组具有DIBH。计算得出的hSDPRT计划使用静态开场传输约85％的规定剂量，使用较不复杂的孤立动态场传输约15％的剂量。使用Wilcoxon符号秩检验比较配对样品之间的剂量学差异。对于门诊治疗的临床调试，使用定制的android应用程序对配有微控制器的呼吸模拟器进行了编程，以模拟自由呼吸和DIBH模式。尽管两个hSDPRT计划在两个图像集上都显示了相同的目标覆盖率，但DIBH技术导致心脏，左前降支动脉和同侧肺结构的各种剂量-体积度量具有统计学上的显着差异。带DIBH的hSDPRT计划减少了总的监控单元（354.9±13.6 MU），屏气时间范围为2.9±0.3到13.7±0.8秒/场，并且对整个机器的吞吐量产生了可接受的影响。当与hSDPRT结合使用时，DIBH是一种有效解决递送不确定性并在心脏和肺部产生实质性保护的可行方法。