Shortening the preparation time of the single prolonged breath-hold for radiotherapy sessions.

Autor: Parkes MJ; School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.; National Institute for Health Research (NIHR)/Wellcome Trust Birmingham Clinical Research Facility, Birmingham, United Kingdom.; Hall Edwards Radiotherapy Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.; Marie Sklodowska-Curie Fellow, Department of Radiation Oncology, University Medical Centre, Amsterdam, Netherlands., Green S; Hall Edwards Radiotherapy Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom., Cashmore J; Hall Edwards Radiotherapy Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom., Ghafoor Q; Hall Edwards Radiotherapy Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom., Clutton-Brock T; National Institute for Health Research (NIHR)/Wellcome Trust Birmingham Clinical Research Facility, Birmingham, United Kingdom.; Department of Anaesthesia and Intensive Care Medicine, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Jazyk: angličtina
Zdroj: The British journal of radiology [Br J Radiol] 2022 Feb 01; Vol. 95 (1130), pp. 20210408. Date of Electronic Publication: 2021 Dec 21.
DOI: 10.1259/bjr.20210408
Abstrakt: Objective: Single prolonged breath-holds of >5 min can be obtained in cancer patients. Currently, however, the preparation time in each radiotherapy session is a practical limitation for clinical adoption of this new technique. Here, we show by how much our original preparation time can be shortened without unduly compromising breath-hold duration.
Methods: 44 healthy subjects performed single prolonged breath-holds from 60% O 2 and mechanically induced hypocapnia. We tested the effect on breath-hold duration of shortening preparation time (the durations of acclimatization, hyperventilation and hypocapnia) by changing these durations and or ventilator settings.
Results: Mean original breath-hold duration was 6.5 ± 0.2 (standard error) min. The total original preparation time (from connecting the facemask to the start of the breath-hold) was 26 ± 1 min. After shortening the hypocapnia duration from 16 to 5 min, mean breath-hold duration was still 6.1 ± 0.2 min ( ns vs the original). After abolishing the acclimatization and shortening the hypocapnia to 1 min (a total preparation time now of 9 ± 1 min), a mean breath-hold duration of >5 min was still possible (now significantly shortened to 5.2 ± 0.6 min, p < 0.001). After shorter and more vigorous hyperventilation (lasting 2.7 ± 0.3 min) and shorter hypocapnia (lasting 43 ± 4 s), a mean breath-hold duration of >5 min (5.3 ± 0.2 min, p < 0.05) was still possible. Here, the final total preparation time was 3.5 ± 0.3 min.
Conclusions: These improvements may facilitate adoption of the single prolonged breath-hold for a range of thoracic and abdominal radiotherapies especially involving hypofractionation.
Advances in Knowledge: Multiple short breath-holds improve radiotherapy for thoracic and abdominal cancers. Further improvement may occur by adopting the single prolonged breath-hold of >5 min. One limitation to clinical adoption is its long preparation time. We show here how to reduce the mean preparation time from 26 to 3.5 min without compromising breath-hold duration.
Databáze: MEDLINE
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