title: Apnea-like suppression of respiratory motion: First evaluation in radiotherapy.
abstract: OBJECTIVE
  Compensation for respiratory motion is needed while administering radiotherapy (RT) to tumors that are moving with respiration to reduce the amount of irradiated normal tissues and potentially decrease radiation-induced collateral damages. The purpose of this study was to test a new ventilation system designed to induce apnea-like suppression of respiratory motion and allow long enough breath hold durations to deliver complex RT.
  
  
  METHODS
  The High Frequency Percussive Ventilation system was initially tested in a series of 10 volunteers and found to be well tolerated, allowing a median breath hold duration of 11.6 min (range 3.9-16.5 min). An evaluation of this system was subsequently performed in 4 patients eligible for adjuvant breast 3D conformal RT, for lung stereotactic body RT (SBRT), lung volumetric modulated arc therapy (VMAT), and VMAT for palliative pleural metastases.
  
  
  RESULTS
  When compared to free breathing (FB) and maximal inspiration (MI) gating, this Percussion Assisted RT (PART) offered favorable dose distribution profiles in 3 out of the 4 patients tested. PART was applied in these 3 patients with good tolerance, without breaks during the "beam on time period" throughout the overall courses of RT. The mean duration of the apnea-like breath hold that was necessary for delivering all the RT fractions was 7.61 min (SD=2.3).
  
  
  CONCLUSIONS
  This first clinical implementation of PART was found to be feasible, tolerable and offers new opportunities in the field of RT for suppressing respiratory motion.
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Péguret
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozsahin
authors.affiliation: Institute of Radiation Physics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Michele
authors.initials: M
authors.lastname: Zeverino
authors.affiliation: Department of Physiotherapy, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Bastien
authors.initials: B
authors.lastname: Belmondo
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: André-Dante
authors.initials: AD
authors.lastname: Durham
authors.affiliation: Department of Pneumology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Alban
authors.initials: A
authors.lastname: Lovis
authors.affiliation: Department of Physiotherapy, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Julien
authors.initials: J
authors.lastname: Simons
authors.affiliation: Department of Physiotherapy, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Long
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Fréderic
authors.initials: F
authors.lastname: Duclos
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: John
authors.initials: J
authors.lastname: Prior
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Alban
authors.initials: A
authors.lastname: Denys
authors.affiliation: Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Beigelman
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Wendy Jeanneret
authors.initials: WJ
authors.lastname: Sozzi
authors.affiliation: Department of Physiotherapy, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Grant
authors.affiliation: The BIRD Institute of Pulmonary Care, Villeneuve-Loubet, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Gautier-Dechaud
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Solange
authors.initials: S
authors.lastname: Peters
authors.affiliation: The BIRD Institute of Pulmonary Care, Villeneuve-Loubet, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Vienne
authors.affiliation: Institute of Radiation Physics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Moeckli
authors.affiliation: Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland. Electronic address: Jean.Bourhis@chuv.ch.
authors.forename: Jean
authors.initials: J
authors.lastname: Bourhis
mesh_terms: D000328:Adult; D001049:Apnea / Q000503:physiopathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D062485:Breath Holding; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009038:Motion; D010865:Pilot Projects; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D016634:Radiosurgery / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012119:Respiration; D014057:Tomography, X-Ray Computed
keywords: Breast; Cancer; HFPV®; Lung; Pulsatile Flow Ventilation™ Percussion Assisted Radiotherapy