WCLC 2025 - Posters & ePosters-EP.09.01 Feasibility of High Pressure Continuous Positive Airway Pressure to Reduce Respiratory Motion in Thoracic Irradiation

EP.09.01 Feasibility of High Pressure Continuous Positive Airway Pressure to Reduce Respiratory Motion in Thoracic Irradiation

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This study from Sheba Medical Center evaluates the feasibility, safety, and tolerability of high-pressure continuous positive airway pressure (HP-CPAP) at 15 cm H2O used during thoracic and breast radiation therapy (RT). HP-CPAP aims to reduce intrathoracic organ motion, decrease irradiated tissue volume, and improve treatment precision by increasing lung volume and reducing internal target volume (ITV) and mean lung dose significantly. It is a passive technique that does not require patient effort.<br /><br />Between 2014 and 2024, 404 patients underwent 512 courses of RT using HP-CPAP, totaling 4,816 treatment fractions. The cohort included breast RT (105 patients), lung stereotactic body RT (SBRT) (209 patients), and fractionated lung or mediastinum RT (90 patients), with 37 receiving concurrent chemoradiotherapy (CCRT). Compliance was excellent in breast RT and SBRT groups, with low discontinuation rates (1-1.9%). Interruptions were more common during fractionated RT, especially in the CCRT subgroup (21.6% discontinuation). Overall, 3.5% of patients discontinued HP-CPAP due to possible CPAP-related toxicities such as presyncope, syncope, dyspnea, hypertension, hoarseness, or discomfort. Additionally, some patients refused or were unable to tolerate HP-CPAP before treatment.<br /><br />The study concludes that HP-CPAP is safe and feasible in clinical practice for respiratory motion management in thoracic and breast RT. It shows minimal complication rates comparable across breast, lung SBRT, and fractionated lung/mediastinum RT populations. Most treatment interruptions in the chemoradiation group likely relate to chemotherapy side effects rather than CPAP itself. Overall, HP-CPAP can be effectively integrated into standard RT protocols to improve targeting accuracy while maintaining patient safety and comfort.

Asset Subtitle

Sarit Appel

Meta Tag

Speaker Sarit Appel

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

HP-CPAP

high-pressure continuous positive airway pressure

thoracic radiation therapy

breast radiation therapy

lung stereotactic body radiation therapy

respiratory motion management

intrathoracic organ motion reduction

internal target volume reduction

chemoradiotherapy

treatment compliance and tolerability