Breast RT patients
Left-sided (heart protection) priority
Early to locally advanced stage
Chest/lung tumors needing respiratory gating
Able to cooperate with breath-hold
Breast cancer radiotherapy requires 5-15 minutes daily, and chest tumors shift with breathing — traditional approaches require larger irradiation areas, increasing cardiopulmonary side effects. Chi Mei Medical Center's Department of Radiation Oncology has 14+ years of experience in respiratory motion-controlled radiotherapy. Since 2008, the Varian Clinac iX linear accelerator was introduced; in 2018, the TrueBeam accelerator with Vision RT Surface Guided Radiation Therapy (SGRT) system was added, providing four control techniques: SGRT, ABC, SDX, and RPM, selectable based on patient conditions. Core technology: (1) Image-guided radiotherapy (IGRT) confirms 3D tumor position before treatment; (2) Surface guidance monitors in real-time during treatment; (3) 2.5mm multi-leaf collimator achieves millimeter precision. Since 2010, 1,700+ respiratory-controlled cases have been completed (455 breast cancer cases, 25% of all breast cancer); SGRT cumulative 144 cases — the most in Taiwan. The procedure adds <1 minute while delivering precise treatment, with normal tissue dose significantly reduced in left-sided breast cancer: right lung -22.5%, left lung -5.8%, heart -32%.
Four respiratory control techniques selected by need
Dual positioning: IGRT + SGRT
TrueBeam 2.5mm multi-leaf collimator
Heart dose significantly reduced by 32%
<1 minute added to treatment time
Multidisciplinary breast cancer team care
Cumulative respiratory-controlled cases: 700+
Breast cancer radiotherapy: 455 cases
Cumulative SGRT: 144 cases (most in Taiwan)
25% of all breast cancer patients
Total treatments: 1,700+ sessions
Right lung dose reduced 22.5%
Left lung dose reduced 5.8%
Heart dose reduced 32%
Treatment time added <1 minute
Reduced new-onset HF, CAD, hypertension rates
QA per Nuclear Safety Commission standards
Weekly new patient case discussions
Individualized positioning molds and plans
Dose verification per international standards
Quarterly Radiation Safety Committee review
2021-2023 satisfaction consistently excellent
Improved post-treatment quality of life
Multidisciplinary breast surgery + radiation oncology care
Case manager full-process support
Patients satisfied with precision breathing control
Multiple international conference presentations
2019 ASTRO Chicago
2022 ASTRO San Antonio
2023 ASTRO San Diego
Helped establish manufacturer training center
Domestic TASTRO and Taiwan Cancer Conference presentations
2-7 SCI papers published
Greatly reduces cardiovascular risk in breast cancer patients
Establishes replicable respiratory control standards
Promotes to multiple hospitals in Taiwan
International leadership in SGRT
Combines with cardio-oncology team for holistic care
