Noninvasive Mechanical Ventilation Is a Promising Way to Improve Lung Cancer Radiation Therapy.

Autor:	Veldman-Landegent JK; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands., van Kesteren Z; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands., Parkes MJ; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands., Stevens MF; Department of Anesthesiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands., van den Aardweg JG; Department of Pulmonology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands., Dieleman EMT; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands., Versteijne E; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands., van Tienhoven G; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands., Bel A; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands., van Dijk IWEM; Department of Radiation Oncology, Amsterdam UMC location Free University, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Advances in radiation oncology [Adv Radiat Oncol] 2024 Nov 16; Vol. 10 (2), pp. 101679. Date of Electronic Publication: 2024 Nov 16 (Print Publication: 2025).
DOI:	10.1016/j.adro.2024.101679
Abstrakt:	Purpose: Accurate radiation therapy (RT) for lung cancer is challenging because of the respiratory motion of the tumor and surrounding organs at risk. Recently, non-invasive mechanical ventilation (NIMV) has been investigated as a novel respiratory motion management strategy. Using NIMV, respiratory motion can be minimized, while a larger lung volume yields less overall lung dose. The purpose of this study was to determine the potential benefit of NIMV to improve lung cancer RT using magnetic resonance imaging (MRI) data of healthy volunteers. Methods and Materials: Twelve healthy volunteers practiced NIMV at 60 breaths per minute (NIMV 60 ) with added positive end-expiratory pressure (PEEP) in 2 sessions and subsequently underwent NIMV 60 in 2 MRI sessions. We acquired single-slice sagittal 2-dimensional MRI images at 2.6 Hz for 6 minutes during free breathing and NIMV 60 . We quantified the motion of all visible cross-sections of lung arteries, as a surrogate for lung tumors, in cranio-caudal and anterior-posterior directions using deformable image registration, distinguishing between 4 quadrants in the lungs (posterior-cranial, posterior-caudal, anterior-caudal, and anterior-cranial). Also, we analyzed average lung area, as a surrogate for lung volume, on the sagittal images using automatic segmentation. Results: All volunteers were successfully trained to be ventilated with NIMV 60 , and completed all sessions. The reduction of the median lung artery motion in each of the quadrants varied from 61% to 67% (from 10.7-29.9 to 3.8-11.7 mm) in cranio-caudal direction and from 51% to 68% (from 8.0-13.7 to 3.0-5.1 mm) in anterior-posterior direction using NIMV 60 . NIMV 60 increased the sagittal lung area by 35% compared with free breathing. Conclusions: NIMV 60 with added PEEP is a promising way to improve lung cancer RT because of reduced respiratory motion and increased lung area compared with free breathing. Competing Interests: Johannes Kornelis Veldman-Landegent reports financial support from Dutch Cancer Foundation (KWF). Michael J. Parkes reports financial support from Marie Sklodowska Cure Individual Fellowship. Arjan Bel reports research grants from General Electric, Varian Medical Systems Inc Elekta, and Karl Reiner. Zdenko van Kesteren reports a non-financial support from General Electric, Varian Medical Systems Inc, and Philips Healthcare. Irma van Dijk reports research grants from Varian Medical Systems Inc and Karl Reiner. The remaining authors do not have any relevant financial disclosures to report. (© 2024 The Authors.)
Databáze:	MEDLINE
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