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

作者：Peguret Nicolas; Ozsahin Mahmut; Zeverino Michele; Belmondo Bastien; Durham Andre Dante; Lovis Alban; Simons Julien; Long Olivier; Duclos Frederic; Prior John; Denys Alban; Beigelman Catherine; Sozzi Wendy Jeanneret; Grant Kathleen; Gautier Dechaud Veronique; Peters Solange; Vienne Monique; Moeckli Raphael; Bourhis Jean^*

来源：Radiotherapy and Oncology, 2016, 118(2): 220-226.

DOI：10.1016/j.radonc.2015.10.011

• Cancer
• Lung
• Breast
• HFPV (R)
• Pulsatile Flow Ventilation (TM) Percussion
• Assisted Radiotherapy

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.

• 出版日期2016-2