Apnea-like suppression of respiratory motion: First evaluation in radiotherapy

Abstract Background and purpose Compensation for respiratory motion is needed while administering radiotherapy (RT) to tumors that are moving with respiration to reduce the amount of irradiated normal tissues and potentially decrease radiation-induced collateral damages. The purpose of this study wa...

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Bibliographic Details
Published in:Radiotherapy and oncology 2016-02, Vol.118 (2), p.220-226
Main Authors: Péguret, Nicolas, Ozsahin, Mahmut, Zeverino, Michele, Belmondo, Bastien, Durham, André-Dante, Lovis, Alban, Simons, Julien, Long, Olivier, Duclos, Fréderic, Prior, John, Denys, Alban, Beigelman, Catherine, Sozzi, Wendy Jeanneret, Grant, Kathleen, Gautier-Dechaud, Véronique, Peters, Solange, Vienne, Monique, Moeckli, Raphael, Bourhis, Jean
Format: Article
Language:English
Subjects:
Adult
Apnea - physiopathology
Breast
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - radiotherapy
Breath Holding
Cancer
Feasibility Studies
Female
Hematology, Oncology and Palliative Medicine
HFPV
Humans
Lung
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - radiotherapy
Male
Middle Aged
Motion
Pilot Projects
Pleural Neoplasms - diagnostic imaging
Pleural Neoplasms - radiotherapy
Pulsatile Flow Ventilation™ Percussion Assisted Radiotherapy
Radiosurgery - methods
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Conformal - methods
Radiotherapy, Intensity-Modulated - methods
Respiration
Tomography, X-Ray Computed
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Summary:Abstract Background and purpose Compensation for respiratory motion is needed while administering radiotherapy (RT) to tumors that are moving with respiration to reduce the amount of irradiated normal tissues and potentially decrease radiation-induced collateral damages. The purpose of this study was to test a new ventilation system designed to induce apnea-like suppression of respiratory motion and allow long enough breath hold durations to deliver complex RT. Material and methods The High Frequency Percussive Ventilation system was initially tested in a series of 10 volunteers and found to be well tolerated, allowing a median breath hold duration of 11.6 min (range 3.9–16.5 min). An evaluation of this system was subsequently performed in 4 patients eligible for adjuvant breast 3D conformal RT, for lung stereotactic body RT (SBRT), lung volumetric modulated arc therapy (VMAT), and VMAT for palliative pleural metastases. Results When compared to free breathing (FB) and maximal inspiration (MI) gating, this Percussion Assisted RT (PART) offered favorable dose distribution profiles in 3 out of the 4 patients tested. PART was applied in these 3 patients with good tolerance, without breaks during the “beam on time period” throughout the overall courses of RT. The mean duration of the apnea-like breath hold that was necessary for delivering all the RT fractions was 7.61 min (SD = 2.3). Conclusions This first clinical implementation of PART was found to be feasible, tolerable and offers new opportunities in the field of RT for suppressing respiratory motion.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2015.10.011