Benefits of Continuous Positive Airway Pressure (CPAP) During Radiation Therapy: A Prospective Trial

Continuous and bilevel positive airway pressure may improve radiotherapy delivery in patients with intra-thoracic tumors

“…We confirm previous research [10] , [11] , [23] , [24] , [25] that has demonstrated that the application of CPAP in patients with lung cancer results in increased lung inflation. Earlier studies also reported a reduction in tumor motion with high levels of pressure [10] , [11] However, we could not detect a decrease in estimated tidal volume when high pressure levels were administered.…”

“…We confirm previous research [10] , [11] , [23] , [24] , [25] that has demonstrated that the application of CPAP in patients with lung cancer results in increased lung inflation. Earlier studies also reported a reduction in tumor motion with high levels of pressure [10] , [11] However, we could not detect a decrease in estimated tidal volume when high pressure levels were administered. Interestingly, upon examining individual values, while the overall findings were not statistically significant, it appeared that smaller estimated tidal volumes were observed during CPAP with lower pressure levels compared to higher pressure levels.…”

“…In addition, this increased lung inflation displaces healthy lung tissue further away from the tumor and radiation beam and decrease lung density, thereby reducing incidental radiation dose to healthy tissues [10] . Earlier studies examining the application of CPAP at a pressure level of 15 cmH 2 O in patients receiving radiation therapy found a decrease in tumor movement and a decrease in both lung and heart radiation dose compared to spontaneous breathing [10] , [11] . A disadvantage of CPAP is the unpredictable breathing pattern, as the patients determines tidal volume and breathing frequency.…”

Application of Continuous Positive Airway Pressure for Thoracic Respiratory Motion Management: An Assessment in a Magnetic Resonance Imaging–Guided Radiation Therapy Environment

“…In the case of SBRT treatment of lung tumors, the planned target volumes were decreased by 19% to 24% with administration of CPAP. 20 , 29 Another notable takeaway in one study was that radiation therapy with CPAP did not increase treatment setup time compared with free-breathing setup, and the authors concluded CPAP may be a viable option for respiratory management in resource-limited radiation oncology centers. 24 Another clinical question that arises is the viability of CPAP in the population of patients with thoracic malignancies who often have underlying pulmonary comorbidities.…”

Gut Microbiota-Derived l-Histidine/Imidazole Propionate Axis Fights against the Radiation-Induced Cardiopulmonary Injury

“…However, cancer survivors often suffer from adverse side effects that are ineluctably intertwined with treatments such as radiotherapy, chemotherapy, or immunotherapy [ 2 ]. As a first-line therapeutic option for multiple kinds of cancer, about 50% of patients with solid tumors require radiotherapy for curative treatment [ 3 ]. Although advances in delivery technology have transformed the remedy into a more precise treatment, radiotherapy is still entwined with short-term side effects such as mucositis and long-term side effects such as tissue fibrosis [ 4 , 5 ].…”