Michael John Parkes1, Stuart Green2, Warren Kilby3, Jason Cashmore2, Qamar Ghafoor2, Thomas Henry Clutton-Brock4. 1. School of Sport, Exercise & Rehabilitation Sciences, United Kingdom; National Institute for Health Research (NIHR)/Wellcome Trust Birmingham Clinical Research Facility, United Kingdom; Hall Edwards Radiotherapy Group, University Hospitals Birmingham NHS Foundation Trust, United Kingdom. Electronic address: M.J.Parkes@Bham.AC.UK. 2. Hall Edwards Radiotherapy Group, University Hospitals Birmingham NHS Foundation Trust, United Kingdom. 3. Accuray Incorporated, Sunnyvale, United States. 4. National Institute for Health Research (NIHR)/Wellcome Trust Birmingham Clinical Research Facility, United Kingdom; Department of Anaesthesia and Intensive Care Medicine, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, United Kingdom.
Abstract
BACKGROUND & PURPOSE: Multiple, short breath-holds are now used in single radiotherapy treatment sessions. Here we investigated the feasibility and safety of multiple prolonged breath-holds in a single session. We measured how long is a second breath-hold if we prematurely terminate a single, prolonged breath-hold of >5 min either by using a single breath of oxygen (O2), or by reintroducing preoxygenation and hypocapnia. We also investigated the feasibility and safety of undertaking 9 prolonged breath-holds in a row. MATERIALS & METHODS: 30 healthy volunteers with no previous breath-holding experience were trained to perform single prolonged breath-holds safely. RESULTS: Their mean single, prolonged breath-hold duration was 6.1 ± 0.3 se minutes (n = 30). In 18/18 subjects, premature termination (at 5.1 ± 0.2 min) with a single breath of 60% O2, enabled a 2nd safe breath-hold lasting 3.3 ± 0.2 min. In 18/18 subjects, premature termination at 5.3 ± 0.2 min) by reintroducing preoxygenation and hypocapnia, enabled a 2nd safe breath-hold lasting 5.8 ± 0.3 min. 17/17 subjects could safely perform 9 successive prolonged breath-holds, each terminated (at 4.3 ± 0.2 min) by reintroducing preoxygenation and hypocapnia for 3.1 ± 0.2 min. The 9th unconstrained breath-hold (mean of 6.0 ± 0.3 min) lasted as long as their single breath-hold. CONCLUSIONS: Multiple prolonged breath-holds are possible and safe. In a ∼19 min treatment session, it would therefore be possible to have ∼13 min for radiotherapy treatment (3 breath-holds) and ∼6 min for setup and recovery. In a 65 min session, it would be possible to have 41 min for radiotherapy and 25 min for setup and recovery.
BACKGROUND & PURPOSE: Multiple, short breath-holds are now used in single radiotherapy treatment sessions. Here we investigated the feasibility and safety of multiple prolonged breath-holds in a single session. We measured how long is a second breath-hold if we prematurely terminate a single, prolonged breath-hold of >5 min either by using a single breath of oxygen (O2), or by reintroducing preoxygenation and hypocapnia. We also investigated the feasibility and safety of undertaking 9 prolonged breath-holds in a row. MATERIALS & METHODS: 30 healthy volunteers with no previous breath-holding experience were trained to perform single prolonged breath-holds safely. RESULTS: Their mean single, prolonged breath-hold duration was 6.1 ± 0.3 se minutes (n = 30). In 18/18 subjects, premature termination (at 5.1 ± 0.2 min) with a single breath of 60% O2, enabled a 2nd safe breath-hold lasting 3.3 ± 0.2 min. In 18/18 subjects, premature termination at 5.3 ± 0.2 min) by reintroducing preoxygenation and hypocapnia, enabled a 2nd safe breath-hold lasting 5.8 ± 0.3 min. 17/17 subjects could safely perform 9 successive prolonged breath-holds, each terminated (at 4.3 ± 0.2 min) by reintroducing preoxygenation and hypocapnia for 3.1 ± 0.2 min. The 9th unconstrained breath-hold (mean of 6.0 ± 0.3 min) lasted as long as their single breath-hold. CONCLUSIONS: Multiple prolonged breath-holds are possible and safe. In a ∼19 min treatment session, it would therefore be possible to have ∼13 min for radiotherapy treatment (3 breath-holds) and ∼6 min for setup and recovery. In a 65 min session, it would be possible to have 41 min for radiotherapy and 25 min for setup and recovery.
Authors: Z van Kesteren; J K Veldman; M J Parkes; M F Stevens; P Balasupramaniam; J G van den Aardweg; G van Tienhoven; A Bel; I W E M van Dijk Journal: Radiat Oncol Date: 2022-05-21 Impact factor: 4.309
Authors: Michael J Parkes; James P Sheppard; Thomas Barker; Aaron M Ranasinghe; Eshan Senanayake; Thomas H Clutton-Brock; Michael P Frenneaux Journal: Front Physiol Date: 2020-01-20 Impact factor: 4.566
Authors: Vincent Vakaet; Hans Van Hulle; Max Schoepen; Els Van Caelenberg; Annick Van Greveling; Jeroen Holvoet; Chris Monten; Luc De Baerdemaeker; Wilfried De Neve; Marc Coppens; Liv Veldeman Journal: Clin Transl Radiat Oncol Date: 2021-02-23
Authors: Michael John Parkes; Stuart Green; Jason Cashmore; Qamar Ghafoor; Thomas Clutton-Brock Journal: Br J Radiol Date: 2021-12-21 Impact factor: 3.039
Authors: Evan Liang; Jennifer L Dolan; Eric D Morris; Jonathan Vono; Luisa F Bazan; Mei Lu; Carri K Glide-Hurst Journal: Adv Radiat Oncol Date: 2022-01-04
Authors: Michael Parkes; Jason Cashmore; Stuart Green; Thomas Clutton-Brock; Irma Van Dijk; Zdenko van Kesteren; Geertjan van Tienhoven; Arjan Bel; Joost van den Aardweg; Markus Stevens Journal: Br J Radiol Date: 2020-06-02 Impact factor: 3.039