Feasibility of the use of the Active Breathing Co ordinator (ABC) in patients receiving radical radiotherapy for non-small cell lung cancer (NSCLC).
BACKGROUND
One method to overcome the problem of lung tumour movement in patients treated with radiotherapy is to restrict tumour motion with an active breathing control (ABC) device. This study evaluated the feasibility of using ABC in patients receiving radical radiotherapy for non-small cell lung cancer.


METHODS
Eighteen patients, median (range) age of 66 (44-82) years, consented to the study. A training session was conducted to establish the patient's breath hold level and breath hold time. Three planning scans were acquired using the ABC device. Reproducibility of breath hold was assessed by comparing lung volumes measured from the planning scans and the volume recorded by ABC. Patients were treated with a 3-field coplanar beam arrangement and treatment time (patient on and off the bed) and number of breath holds recorded. The tolerability of the device was assessed by weekly questionnaire. Quality assurance was performed on the two ABC devices used.


RESULTS
17/18 patients completed 32 fractions of radiotherapy using ABC. All patients tolerated a maximum breath hold time >15s. The mean (SD) patient training time was 13.8 (4.8)min and no patient found the ABC very uncomfortable. Six to thirteen breath holds of 10-14 s were required per session. The mean treatment time was 15.8 min (5.8 min). The breath hold volumes were reproducible during treatment and also between the two ABC devices.


CONCLUSIONS
The use of ABC in patients receiving radical radiotherapy for NSCLC is feasible. It was not possible to predict a patient's ability to hold breath. A minimum tolerated breath hold time of 15 s is recommended prior to commencing treatment.
Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Surrey, UK. Helen.McNair@rmh.nhs.uk
Helen A
HA
McNair
Juliet
J
Brock
J Richard N
JR
Symonds-Tayler
Sue
S
Ashley
Sally
S
Eagle
Philip M
PM
Evans
Anthony
A
Kavanagh
Niki
N
Panakis
Michael
M
Brada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009068:Movement; D012119:Respiration; D055425:Respiratory-Gated Imaging Techniques / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed