News | Radiation Therapy | May 12, 2016

Prolonged Breath Holds Could Help in Targeted Breast Cancer Radiotherapy

U.K. study demonstrates patients can be trained to achieve single prolonged breath-holds of more than five minutes to deliver radiation dose in a single breath-hold

breast cancer, radiation therapy, extended breath-hold, University of Birmingham study

May 12, 2016 — Researchers in the United Kingdom have successfully shown for the first time that breast cancer patients can be trained to achieve single prolonged breath-holds of over five minutes. These findings open the door for targeted radiotherapy to be administered with just one dose in each daily session.

A typical radiotherapy beam in each daily session takes two minutes to deliver, with shaped radiation beams directed from several angles to intersect at the cancerous tumor. Because patients are not able to hold their breath for this long, most radiotherapy treatment is delivered while still breathing, and the ventilatory motion of the chest increases the risk of damage to nearby healthy tissue.

Clinical practice for some breast cancer patients is due to change with the introduction of repeated breath-holds of around 20 seconds, to provide a stable target for the treatment, given over a number of doses in each session.

But the Birmingham team have demonstrated that the treatment in each session could now be delivered to patients in a single breath-hold.

The research “Safely prolonging single breath-holds to >5 minutes in cancer patients; feasibility and applications for radiotherapy“ published in the British Journal of Radiology, builds on previous studies of healthy volunteers who were able to reach mean breath holds of seven minutes.

Dr. Mike Parkes, from the University of Birmingham, explained, “The physiology of breath holding is well understood on the whole, but has been somewhat overlooked in medical research because until now it hadn’t any obvious clinical application.”

“Following on from our preliminary work on healthy subjects, we wanted to see if we could help patients with breast cancer to achieve a breath hold of over two minutes to allow a radiotherapy treatment to be delivered in a single breath-hold.”

Fifteen patients who were undergoing radiotherapy were recruited to the trial and trained to extend their breath-holds safely. Patients are trained on how to maintain a relaxed posture, to practice inhaling and exhaling to maximum effect and then to assist them naturally to raise their blood oxygen levels and reduce their blood carbon dioxide levels, by preoxygenation and mechanically induced hypocapnia.

The average breath hold of patients after the training was 5.3 minutes, significantly more than the required target of 2 minutes.

Parkes continued, “Being able to hit the cancerous tumor accurately is essential to avoid damage to other areas, including the heart muscle. Having a stable chest that we can target in one dose could be invaluable in protecting the surrounding tissue.”

“Although 5-minute breath-holds may seem astonishing to people, it is perfectly natural and safe for patients. Actually, anyone can do it. Patients are carefully monitored throughout the process and if their oxygen levels drop or their blood pressure rises above a certain level we would step in. The safety levels we use are very conservative so there is no risk attached.”

Of all 15 patients undergoing radiotherapy, 13 also had chemotherapy and two were taking herceptin.

The Birmingham team, working with clinical teams at University Hospitals Birmingham NHS Foundation Trust, believe that being able to assist patients in achieving a single breath-hold could greatly improve the long-term survival and quality of life of breast cancer patients.

The trial was funded by the Queen Elizabeth Hospital Birmingham Charity as part of the Charity’s ongoing multi-million pound support of patients at the hospital.

For more information: www.birpublications.org/journal/bjr

Related Content

RaySearch Releases Version 3A of RayCare Oncology Information System
Technology | Oncology Information Management Systems (OIMS) | July 15, 2019
RaySearch has released RayCare 3A, a new version of the next-generation oncology information system (OIS). RayCare is...
FDA Clears Koios DS Breast 2.0 AI-based Software
News | Ultrasound Women's Health | July 11, 2019
Koios Medical announced its second 510(k) clearance from the U.S. Food and Drug Administration (FDA).
IBA Launches Monte Carlo Patient QA for Varian Halcyon at AAPM 2019
Technology | Quality Assurance (QA) | July 10, 2019
IBA announced the launch of the latest functionality of the SciMoCa Monte Carlo Patient QA solution at the 61st annual...
Researchers Use Artificial Intelligence to Deliver Personalized Radiation Therapy
News | Radiation Therapy | July 09, 2019
New Cleveland Clinic-led research shows that artificial intelligence (AI) can use medical scans and health records to...
The Beamscan 3-D water phantom with the Varian Halcyon radiotherapy system

The Beamscan 3-D water phantom with the Varian Halcyon radiotherapy system. Image courtesy of PTW.

News | Quality Assurance (QA) | July 08, 2019
At this year’s American Association of Physicists in Medicine (AAPM) show, July 14-18 in San Antonio, Texas, PTW will...
Aktina Medical Partners With Elekta for Global Distribution of Interlocking SRS Cones
News | Radiation Therapy | July 05, 2019
Aktina Medical announced that Elekta Instrument AB, based in Sweden, will offer and distribute the Aktina line of...
Delta T1 Maps Provide Quantitative, Automated Solution to Assess Brain Tumor Burden
News | Neuro Imaging | July 05, 2019
Imaging Biometrics LLC (IB) a subsidiary of IQ-AI Ltd., is highlighting a recently published study in the American...
Civco Displaying Universal Couchtop ProForm Head & Neck Solution at AAPM
News | Patient Positioning Radiation Therapy | July 03, 2019
The upcoming release of Civco’s Universal Couchtop ProForm Head & Neck Solution will allow proton therapy centers...
Therapixel Appoints Matthieu Leclerc-Chalvet as CEO
News | Artificial Intelligence | July 03, 2019
Artificial intelligence (AI) breast cancer screening specialist Therapixel announced the appointment of Matthieu...