Inhale and Exhale Breath Holds to Improve the Therapeutic Ratio in Upper Abdominal Cancers Treated With SBRT

What this Trial Is About

Researchers are evaluating a new radiation therapy technique called INEX RT that uses both inhale and exhale breath holds during the same course of stereotactic body radiation therapy (SBRT) for patients with abdominal cancer. This approach aims to improve radiation dose delivery to the tumor while reducing exposure to nearby critical organs at risk (OARs). The study plans to treat 15 patients expected to benefit from this method based on the proximity of OARs to the tumor. The goal is to increase the radiation dose to the tumor by at least 10% without increasing the dose to adjacent organs, compared to the current standard of using a single breath hold phase. Participants will have radiation treatments planned using images taken during both inhale and exhale breath holds. For radiation courses with an odd number of treatment sessions, the breath hold phase with better stability or anatomical benefit will be used for the extra session. Patients who may benefit from the combined breath hold technique will receive a treatment plan that splits radiation delivery between inhale and exhale phases. Additional imaging with cone beam CT scans will be done on treatment days to monitor positioning. During the study, patients will undergo radiation therapy with this new technique and have images taken to assess organ movement between breath holds. The main outcome measured is the total radiation dose delivered to both the tumor and critical organs over 12 months. Secondary outcomes include changes in organ position between deep inhale and exhale breath holds. The study involves monitoring radiation delivery accuracy and safety, with follow-up lasting up to a year after treatment.

Inhale and Exhale Breath Holds to Improve the Radiation Therapy Accuracy in People With Upper Abdominal Cancers