Mechanically-induced deep inspiration breath holds for breast cancer and moving tumours: clinical implementation of a novel motion mitigation strategy
(2024)
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- Authors
- Supervisors
- Geets, Xavier
- Abstract
- Breath hold (BH) plays an important role in the arsenal of modern radiotherapy techniques. Irradiation during BH for left breast cancer allows to reduce cardiac dose levels by moving the heart away from the irradiated breast. A critical point consists in maximising cardiac sparing by increasing the deepness of apnea. Another challenge is to ensure positional breast reproducibility and stability during each BH. There is currently no method that satisfactorily combines these two imperatives. For lesions subject to breathing-related motion, e.g., lung or liver tumours, BH enables to mitigate the tumour motion amplitude and therefore reduces the irradiation volume. The potential lack of positional reproducibility and stability entails a risk of geographical miss. The feasibility of performing multiple BH may also be hampered by the patient's poor general condition. Thanks to the mechanical support faithfully replicated with oxygen-enriched air, non-invasive mechanical ventilation could optimise BH by addressing all the points mentioned above. Pioneering works on healthy volunteers and patients have shown encouraging results. Importantly, this technique requires no prior sedation and uses an unmodified mechanical ventilator, making it easy to deploy on a routine basis. This thesis aims therefore at better substantiating the added value of mechanical ventilation through clinical trials. Improvement of technologies dedicated to solve the tumour motion issue in the environment of a conventional treatment machine was also investigated.
- Affiliations
Citations
Vander Veken, L. (2024). Mechanically-induced deep inspiration breath holds for breast cancer and moving tumours: clinical implementation of a novel motion mitigation strategy. https://hdl.handle.net/2078.5/29902