title: Preoxygenated hyperventilated hypocapnic apnea-induced radiation (PHAIR) in breast cancer patients.
abstract: BACKGROUND
  The study was performed to quantify the benefit of preoxygenated hyperventilated hypocapnic apnea-induced radiation (PHAIR) for breath hold (BH) time in patients with breast cancer.
  
  
  METHODS
  We compared in a single blind study 6 healthy volunteers and 10 breast cancer patients using PHAIR. Both groups were subdivided into two arms, each including 4min eupnea and hyperventilation with 20 breaths/min to 19-20mmHG FeCO2 before apnea without (hBH) and with 100% oxygen (ohBH). Apnea times were measured with an in-house breathholding device and an adapted ventilator, and blood and respiration gas parameters through our laboratory.
  
  
  RESULTS
  The experiment was well-tolerated by patients without compromising their security. A significant increase in BH was observed upon hBH and ohBH compared to standard breath hold - up to 700% in ohBH. There is evidence that the patients interrupted their breath hold before the actual physiological end.
  
  
  CONCLUSIONS
  PHAIR is a feasible, safe and recommendable technique that could be used to improve BH for high precision radiotherapy. Further research is necessary to obtain a clinical value for this technique.
authors.affiliation: Department of Radiation Oncology, University of Marburg, Germany. amidelis@web.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Roth
authors.forename: Rita
authors.initials: R
authors.lastname: Engenhart-Cabillic
authors.forename: Leo
authors.initials: L
authors.lastname: Eberhardt
authors.forename: Nina
authors.initials: N
authors.lastname: Timmesfeld
authors.forename: Gerd
authors.initials: G
authors.lastname: Strassmann
mesh_terms: D000368:Aged; D001049:Apnea / Q000503:physiopathology; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000503:physiopathology; D016857:Hypocapnia / Q000503:physiopathology; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D017382:Reactive Oxygen Species / Q000378:metabolism; D012119:Respiration; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: D017382:Reactive Oxygen Species; D010100:Oxygen