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The Feasibility of Implementing Deep Inspiration Breath-Hold for Pediatric Radiation Therapy

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@article{c6d62ff57252488ab2badca7f2b5acd2,
title = "The Feasibility of Implementing Deep Inspiration Breath-Hold for Pediatric Radiation Therapy",
abstract = "PURPOSE: Radiation therapy delivery during deep inspiration breath-hold (DIBH) reduces the irradiation of the heart and lungs and is therefore recommended for adults with mediastinal lymphoma. However, no studies have addressed the use of DIBH in children. This pilot study investigates the feasibility of and compliance with DIBH in children.METHODS AND MATERIALS: Children from the age of 5 years were recruited to a training session to assess their ability to perform DIBH. No children received radiation therapy. The children were placed in a potential radiation therapy position. The DIBH was voluntary and monitored using an optical surface system providing visual feedback. Children who performed 3 stable DIBHs of 20 seconds each and remained motionless were deemed DIBH compliant. Compliance, equipment suitability, and coaching were further assessed in a semistructured interview.RESULTS: We included 33 children (18 healthy and 15 hospitalized children with cancer) with a mean age of 8.5 years (range, 5-15). A total of 28 (85{\%}) children were DIBH compliant. Twenty children were deemed immediately DIBH compliant, and 8 were deemed conditionally DIBH compliant, as DIBH compliance was presumed with custom-made immobilization and/or additional DIBH training. Mean age of the DIBH-compliant and the non-DIBH-compliant children was 8.9 years (range, 5-15) and 6 years (range, 5-9), respectively. Only 1 of 15 hospitalized children was not DIBH compliant and only 1 of all 33 children was unable to grasp the DIBH concept. The available DIBH equipment was suitable for children, and 94{\%} reported that they were happy with training and performing DIBH.CONCLUSIONS: This pilot study demonstrated that children from the age of 5 years can potentially comply with the DIBH technique and perform stable and reproducible DIBHs suitable for radiation therapy. Custom-made immobilization and adequate training will potentially increase DIBH compliance. A prospective clinical trial (NCT03315546), investigating the dosimetric benefit of radiation therapy delivery in DIBH compared with free breathing with pediatric patients, has been initiated.",
keywords = "Adolescent, Breath Holding, Child, Child, Preschool, Feasibility Studies, Female, Humans, Male, Patient Compliance, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Computer-Assisted",
author = "Lundgaard, {Anni Young} and Mirjana Josipovic and Rechner, {Laura Ann} and Bidstrup, {Pernille Envold} and Rune Hansen and Damkjaer, {Sidsel Skov} and Morten Joergensen and Akmal Safwat and Lena Specht and Hjalgrim, {Lisa Lyngsie} and Maraldo, {Maja Vestmoe}",
note = "Copyright {\circledC} 2020 Elsevier Inc. All rights reserved.",
year = "2020",
month = "4",
day = "1",
doi = "10.1016/j.ijrobp.2019.12.025",
language = "English",
volume = "106",
pages = "977--984",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc",
number = "5",

}

RIS

TY - JOUR

T1 - The Feasibility of Implementing Deep Inspiration Breath-Hold for Pediatric Radiation Therapy

AU - Lundgaard, Anni Young

AU - Josipovic, Mirjana

AU - Rechner, Laura Ann

AU - Bidstrup, Pernille Envold

AU - Hansen, Rune

AU - Damkjaer, Sidsel Skov

AU - Joergensen, Morten

AU - Safwat, Akmal

AU - Specht, Lena

AU - Hjalgrim, Lisa Lyngsie

AU - Maraldo, Maja Vestmoe

N1 - Copyright © 2020 Elsevier Inc. All rights reserved.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - PURPOSE: Radiation therapy delivery during deep inspiration breath-hold (DIBH) reduces the irradiation of the heart and lungs and is therefore recommended for adults with mediastinal lymphoma. However, no studies have addressed the use of DIBH in children. This pilot study investigates the feasibility of and compliance with DIBH in children.METHODS AND MATERIALS: Children from the age of 5 years were recruited to a training session to assess their ability to perform DIBH. No children received radiation therapy. The children were placed in a potential radiation therapy position. The DIBH was voluntary and monitored using an optical surface system providing visual feedback. Children who performed 3 stable DIBHs of 20 seconds each and remained motionless were deemed DIBH compliant. Compliance, equipment suitability, and coaching were further assessed in a semistructured interview.RESULTS: We included 33 children (18 healthy and 15 hospitalized children with cancer) with a mean age of 8.5 years (range, 5-15). A total of 28 (85%) children were DIBH compliant. Twenty children were deemed immediately DIBH compliant, and 8 were deemed conditionally DIBH compliant, as DIBH compliance was presumed with custom-made immobilization and/or additional DIBH training. Mean age of the DIBH-compliant and the non-DIBH-compliant children was 8.9 years (range, 5-15) and 6 years (range, 5-9), respectively. Only 1 of 15 hospitalized children was not DIBH compliant and only 1 of all 33 children was unable to grasp the DIBH concept. The available DIBH equipment was suitable for children, and 94% reported that they were happy with training and performing DIBH.CONCLUSIONS: This pilot study demonstrated that children from the age of 5 years can potentially comply with the DIBH technique and perform stable and reproducible DIBHs suitable for radiation therapy. Custom-made immobilization and adequate training will potentially increase DIBH compliance. A prospective clinical trial (NCT03315546), investigating the dosimetric benefit of radiation therapy delivery in DIBH compared with free breathing with pediatric patients, has been initiated.

AB - PURPOSE: Radiation therapy delivery during deep inspiration breath-hold (DIBH) reduces the irradiation of the heart and lungs and is therefore recommended for adults with mediastinal lymphoma. However, no studies have addressed the use of DIBH in children. This pilot study investigates the feasibility of and compliance with DIBH in children.METHODS AND MATERIALS: Children from the age of 5 years were recruited to a training session to assess their ability to perform DIBH. No children received radiation therapy. The children were placed in a potential radiation therapy position. The DIBH was voluntary and monitored using an optical surface system providing visual feedback. Children who performed 3 stable DIBHs of 20 seconds each and remained motionless were deemed DIBH compliant. Compliance, equipment suitability, and coaching were further assessed in a semistructured interview.RESULTS: We included 33 children (18 healthy and 15 hospitalized children with cancer) with a mean age of 8.5 years (range, 5-15). A total of 28 (85%) children were DIBH compliant. Twenty children were deemed immediately DIBH compliant, and 8 were deemed conditionally DIBH compliant, as DIBH compliance was presumed with custom-made immobilization and/or additional DIBH training. Mean age of the DIBH-compliant and the non-DIBH-compliant children was 8.9 years (range, 5-15) and 6 years (range, 5-9), respectively. Only 1 of 15 hospitalized children was not DIBH compliant and only 1 of all 33 children was unable to grasp the DIBH concept. The available DIBH equipment was suitable for children, and 94% reported that they were happy with training and performing DIBH.CONCLUSIONS: This pilot study demonstrated that children from the age of 5 years can potentially comply with the DIBH technique and perform stable and reproducible DIBHs suitable for radiation therapy. Custom-made immobilization and adequate training will potentially increase DIBH compliance. A prospective clinical trial (NCT03315546), investigating the dosimetric benefit of radiation therapy delivery in DIBH compared with free breathing with pediatric patients, has been initiated.

KW - Adolescent

KW - Breath Holding

KW - Child

KW - Child, Preschool

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Male

KW - Patient Compliance

KW - Radiotherapy Planning, Computer-Assisted

KW - Radiotherapy, Computer-Assisted

U2 - 10.1016/j.ijrobp.2019.12.025

DO - 10.1016/j.ijrobp.2019.12.025

M3 - Journal article

VL - 106

SP - 977

EP - 984

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 5

ER -

ID: 61015995