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Войти в исследования The British journal of radiology · 2025
Minimizing preparation time for repeated prolonged deep-inspiration breath holds during breast cancer irradiation using pre-oxygenation with high-flow nasal oxygen and voluntary hyperventilation.
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Vakaet Vincent, Van Hulle Hans, De Noyette Renée, Schoepen Max, Deseyne Pieter, Huybrechts Vincent, Van Caelenberg Els, Van Greveling Annick, Monten Chris, De Baerdemaeker Luc, De Neve Wilfried, Coppens Marc, Veldeman Liv
Аннотация
OBJECTIVES: Deep inspiration breath-holds (DIBHs) reduce heart and lung toxicity during breast cancer radiotherapy. Consecutive DIBHs are stressful, time-consuming, and leads to position changes. To facilitate the introduction of pre-oxygenation using high-flow nasal oxygen (HFNO) and hyperventilation to prolong DIBHs (L-DIBHs), we examined the effect of hyperventilation time on the duration of L-DIBHs. Additionally, to minimize total treatment time, the feasibility of several successive L-DIBHs was examined.
METHODS: Our previous protocol imposed 3 min of hyperventilation at 16 breaths per minute with pre-oxygenation using HFNO, in prone position. In the first phase, the effect of hyperventilation time on the length of the L-DIBH was investigated. The aim of the second phase was to investigate the feasibility of shorter preparation times before the second and third L-DIBH in the case of 3 consecutive L-DIBHs of at least 2 minutes.
RESULTS: There is a positive but weak correlation between preparation time and L-DIBH duration. With either 3 minutes 30 seconds or 6 minutes 20 seconds (depending on fitness) of voluntary hyperventilation duration, 93% of subjects could hold 3 consecutive L-DIBHs for over 2 minutes. The median duration of the third and last L-DIBH was 3 minutes 17 seconds (SD 1 min 4 seconds).
CONCLUSION: A weak relationship exists between the hyperventilation time and L-DIBH duration. Repeating L-DIBHs with shorter preparations is achievable, resulting in a shorter total treatment time required.
ADVANCES IN KNOWLEDGE: It is possible to perform repeated L-DIBHs for breast cancer irradiation using HFNO and hyperventilation.
METHODS: Our previous protocol imposed 3 min of hyperventilation at 16 breaths per minute with pre-oxygenation using HFNO, in prone position. In the first phase, the effect of hyperventilation time on the length of the L-DIBH was investigated. The aim of the second phase was to investigate the feasibility of shorter preparation times before the second and third L-DIBH in the case of 3 consecutive L-DIBHs of at least 2 minutes.
RESULTS: There is a positive but weak correlation between preparation time and L-DIBH duration. With either 3 minutes 30 seconds or 6 minutes 20 seconds (depending on fitness) of voluntary hyperventilation duration, 93% of subjects could hold 3 consecutive L-DIBHs for over 2 minutes. The median duration of the third and last L-DIBH was 3 minutes 17 seconds (SD 1 min 4 seconds).
CONCLUSION: A weak relationship exists between the hyperventilation time and L-DIBH duration. Repeating L-DIBHs with shorter preparations is achievable, resulting in a shorter total treatment time required.
ADVANCES IN KNOWLEDGE: It is possible to perform repeated L-DIBHs for breast cancer irradiation using HFNO and hyperventilation.