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We would like to study if a systematic breathing coaching could improve the efficiency of left breast surface-guided DIBH (SG-DIBH) radiotherapy treatment.

25 left breast DIBH patients, who were treated between June 2020 and May 2021, were divided into two groups. Group A (before March 2021) consisted of 13 patients which the CT simulation was done without systematic breathing coaching. While a systematic breathing coaching was conducted to 12 patients in Group B (after March 2021). Group A patients were only given simple breath hold instruction and repeated the breath hold for 3 times on the CT couch before the scanning. Before entering the CT simulation room, an educating video were shown to Group B patients to understand the rationales of DIBH and how to ensure a good breath hold during the scanning and treatment. Before the scanning, they had to repeat the breath hold on the CT couch for at least 5 times to ensure the reproducibility. Each breath hold had to last for at least 25 seconds. They were also instructed to practise at home for 10-15 minutes every day until the first day of the treatment. Both Group A and Group B patients were positioned using SGRT system (AlignRT, Vision RT, UK), 6-field IMRT treatment technique. The treatment times recorded by the machine (Varian, Palo Alto, CA) were retrieved. The treatment time was defined as the duration of CBCT scanning and beam on time of each treatment field, patient positioning time was not included. t-test was used for data analysis.

The treatment time for Group A and B were 528.86±261.64 seconds and 448.06±159.89 seconds. p value is statistically significant (p<0.05). The average treatment time was reduced by 14.9%.

SG-DIBH treatment efficiency can be greatly improved with effective systematic breathing coaching implementation in the department. This will further enhance the patient’s treatment compliancy and experience as well.