ESTRO 2025 - Abstract Book

S4085

RTT - Patient care, preparation, immobilisation and IGRT verification protocols

ESTRO 2025

Patients were trained to breath with CPAP device using a facial mask to reach a maximum individual tolerable air pressure ≤15 cmH2O. After 30 minutes of CPAP breathing under the maximum tolerable air pressure, a planning CT, in supine position on the breast board, was performed for all patients. Under CPAP breathing, the cardiac respiratory parameters, neurological condition and potential adverse events were monitored. The time to reach the maximum tolerable air pressure and the overall planning CT time were assessed. By the end of the procedure, a 28-item survey was distributed to all patients to evaluate patient’s tolerance and experience of radiotherapy planning with CPAP breathing. Results: Mean age at diagnosis was 51 (33-88) years. Three patients were smokers and one patient had claustrophobia. Cardiovascular history was reported in 20% of patients whereas one patient had respiratory history (allergic asthma). Seventy percent of patients had no prior information about CPAP. The mean self-assessed CPAP knowledge score was 0.9/10, with only 2 patients having as score ≥5. The average time to reach the maximum individual tolerable air pressure was 16 min. The overall planning CT time, including the CPAP setup and imaging, was 46 min per patient. The maximum tolerable airway pressure was 15 cmH2O for 78% of patients. No significant adverse events were reported during the planning CT with CPAP, and all patients successfully completed the procedure. No patient interrupted CPAP breathing for poor tolerance. Minimal discomfort during the procedure was reported by 36% of patients, most commonly related to mouth/nasal dryness (Table 1). All patients agreed that the device noise wasn’t bothersome and 96% of patients found the facial mask comfortable. Only 30% of patients felt that the duration of CT planning with CPAP was “too long”. Patient global tolerance of CPAP breathing was good with 94% of patients agreeing that “Overall experience of CT planning under CPAP breathing was comfortable”.

Conclusion: This study showed that CT planning under CPAP breathing was feasible and well-tolerated. Patient’s feedback suggests that CPAP could be easily integrated into routine radiotherapy planning for left-sided breast cancer. Future studies are needed to assess CPAP broader clinical application.

Keywords: breast radiotherapy; CPAP; patient tolerance