PURPOSE Radiation therapy delivery during deep inspiration breath-hold (DIBH) reduces the irradiation of the heart and lungs and is therefore recommended for adults with mediastinal lymphoma. However, no studies have addressed the use of DIBH in children. This pilot study investigates the feasibility of and compliance with DIBH in children. METHODS AND MATERIALS Children from the age of 5 years were recruited to a training session to assess their ability to perform DIBH. No children received radiation therapy. The children were placed in a potential radiation therapy position. The DIBH was voluntary and monitored using an optical surface system providing visual feedback. Children who performed 3 stable DIBHs of 20 seconds each and remained motionless were deemed DIBH compliant. Compliance, equipment suitability, and coaching were further assessed in a semistructured interview. RESULTS We included 33 children (18 healthy and 15 hospitalized children with cancer) with a mean age of 8.5 years (range, 5-15). A total of 28 (85%) children were DIBH compliant. Twenty children were deemed immediately DIBH compliant, and 8 were deemed conditionally DIBH compliant, as DIBH compliance was presumed with custom-made immobilization and/or additional DIBH training. Mean age of the DIBH-compliant and the non-DIBH-compliant children was 8.9 years (range, 5-15) and 6 years (range, 5-9), respectively. Only 1 of 15 hospitalized children was not DIBH compliant and only 1 of all 33 children was unable to grasp the DIBH concept. The available DIBH equipment was suitable for children, and 94% reported that they were happy with training and performing DIBH. CONCLUSIONS This pilot study demonstrated that children from the age of 5 years can potentially comply with the DIBH technique and perform stable and reproducible DIBHs suitable for radiation therapy. Custom-made immobilization and adequate training will potentially increase DIBH compliance. A prospective clinical trial (NCT03315546), investigating the dosimetric benefit of radiation therapy delivery in DIBH compared with free breathing with pediatric patients, has been initiated.

中文翻译：

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在小儿放射治疗中实施深吸气屏气的可行性。

目的深吸气屏息（DIBH）期间进行放射治疗可减少心脏和肺部的放射，因此建议用于纵隔淋巴瘤的成人。但是，尚无研究涉及在儿童中使用DIBH。这项初步研究调查了DIBH在儿童中的可行性和依从性。方法和材料招募5岁以下的儿童参加培训，以评估他们进行DIBH的能力。没有儿童接受放射治疗。孩子们被放置在潜在的放射治疗位置。DIBH是自愿的，并使用提供视觉反馈的光学表面系统进行监控。进行3次稳定的DIBH（每人20秒）并且保持静止的孩子被认为是符合DIBH的。合规性，设备适用性，半结构化访谈进一步评估了教练和教练。结果我们纳入了33名儿童（18名健康儿童和15名住院癌症儿童），平均年龄为8.5岁（5-15岁）。共有28名（85％）儿童符合DIBH标准。20名儿童被视为立即符合DIBH的要求，而8名儿童被视为有条件地符合DIBH的要求，因为可以通过定制的固定装置和/或进行额外的DIBH培训来假定符合DIBH。符合DIBH的儿童和不符合DIBH的儿童的平均年龄分别为8.9岁（5-15岁）和6岁（5-9岁）。15名住院儿童中只有1名不符合DIBH标准，而33名儿童中只有1名无法掌握DIBH概念。可用的DIBH设备适合儿童，94％的人表示他们对培训和表演DIBH感到满意。结论这项初步研究表明，5岁以下的儿童有可能遵守DIBH技术，并进行稳定且可重复的DIBH，适用于放射治疗。定制的固定装置和足够的培训将有可能提高DIBH的依从性。一项前瞻性临床试验（NCT03315546）已开始研究，与小儿科患者的自由呼吸相比，DIBH中放射治疗的剂量学益处。