KEY POINTS
- This prospective, single-institution pilot trial reported the first 4 patients treated with percussive ventilation breath-hold stereotactic ablative radiotherapy for primary lung cancer or pulmonary metastases.
- Three patients received single-fraction treatment, while one received 4 fractions. Final cone-beam computed tomography verification and treatment delivery were planned within the same assisted breath-hold.
- Three of four patients completed final imaging and treatment within one percussive ventilation breath-hold. The fourth required a second breath-hold after a software malfunction interrupted delivery.
- Mean breath-hold duration per fraction was 6 minutes 56 seconds, including final imaging and treatment. Mean delivery time was 2 minutes 22 seconds, with a mean duty cycle of 93.5%.
- Dry mouth occurred in 75%, while dizziness and watery eyes each occurred in 25%. All adverse events were grade 1 and resolved within 24 hours.
CLINICAL TAKEAWAY
Percussive ventilation may allow final volumetric verification and lung stereotactic ablative radiotherapy delivery to occur during the same extended breath-hold, avoiding uncertainty between separate breath-holds. However, these are initial observations from only four patients without a comparator, so the findings remain preliminary and are not practice-changing.
SOURCE
International Journal of Radiation Oncology, Biology, Physics