None listed
Conditions
Brief summary
This is a pilot study investigating whether CPAP improves the quality of Radiotherapy treatment for centralised lung cancers. Respiratory motion is an obstacle in radiotherapy treatments, especially when delivering high radiation doses to lung tumours in stereotactic ablative radiotherapy (SABR) or hypofractionated radiotherapy treatments. It is well known that a reduction in respiratory motion during radiotherapy treatment improves the accuracy of radiation delivery to the tumour and reduces the amount of radiation delivered to surrounding healthy tissues. CPAP is a device that applies positive air pressure to the airways. Recent publications have investigated the use of CPAP for motion management in Lung Radiotherapy treatments with encouraging results. It is suggested that CPAP reduces tumour motion, making it an easier radiotherapy target, and additionally displaces healthy surrounding structures away from the tumour and radiation field, allowing more healthy tissue to be spared. No study has specifically investigated how CPAP effects the quality of radiotherapy treatments for centralised lung tumours and how CPAP alters the geometric displacement of surrounding structures to centrally located lung tumours. If surrounding critical structures can be further displaced from the tumour by using CPAP, then potentially a higher prescription dose or more optimal treatment delivery regime may be achievable. Data from this study will inform a future larger clinical trial.
Interventions
Study participants will undergo Computed Tomography (CT) imaging as per standard clinical protocol. Approximately 10minutes later that participant will undergo CT imaging while attached to continuous positive airway pressure therapy (CPAP). The participant may also have Radiotherapy treatment delivered while attached to CPAP.
Prior to imaging, the participant will have a CPAP face-mask fitted and a tolerable pressure for the participant in the range of 10-20cm H20 will be determined. This will
Study participants will undergo Computed Tomography (CT) imaging as per standard clinical protocol. Approximately 10minutes later that participant will undergo CT imaging while attached to continuous positive airway pressure therapy (CPAP). The participant may also have Radiotherapy treatment delivered while attached to CPAP. Prior to imaging, the participant will have a CPAP face-mask fitted and a tolerable pressure for the participant in the range of 10-20cm H20 will be determined. This will occur at the hospital under the instruction of Respiratory Technicians. The participant will then have CT images acquired without CPAP as per standard clinical protocol. The participant will remain in the CT while staff attach CPAP. Approximately 10 minutes later the participant will then have CT images acquired with CPAP. This will be performed in the Radiation Oncology department of the hospital and performed by Radiation Therapists. If CPAP improves the quality of Radiotherapy treatment for the individual participant, the participant will also use CPAP during their Radiotherapy treatment delivery, with each delivery taking approximately half an hour. Participants will be asked to complete a short questionnaire after the CT imaging and first, middle, and last day of Radiotherapy treatment (if CPAP is used during Radiotherapy treatment) to indicate their comfort and tolerability of using CPAP during CT and Radiotherapy.
Sponsors
Auckland City Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Crossover
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients who meet the following criteria will be eligible: -Aged 16 years or older. - Diagnosed with centrally located lung tumour, defined as within 2cm in all directions of any mediastinal critical structure, including the bronchial tree, esophagus, heart, brachial plexus, major vessels, spinal cord, phrenic nerve and recurrent laryngeal nerve. - Prescribed (by an Radiation Oncology) a Radiotherapy Treatment of 60Gy in 8 fractions (SABR) or 48Gy in 12 fractions (hypofractionation). - Meets the current departmental inclusion criteria for a treatment prescription of 60Gy in 8 fractions (SABR) or 48Gy in 12 fractions (hypofractionation).
Exclusion criteria
Patients that have significant comorbidities that may result in them not tolerating treatment with CPAP (recent surgery, respiratory conditions, inappropriate age, and disabilities). Patients who are unable to provide informed consent or who refuse to use CPAP.
Outcome results
None listed