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Updated: Jun 2, 2026

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
Published on: July 3, 2014
Preoxygenated hyperventilated hypocapnic apnea-induced radiation (PHAIR) in breast cancer patients
Johannes Roth1, Rita Engenhart-Cabillic, Leo Eberhardt
1Department of Radiation Oncology, University of Marburg, Germany. amidelis@web.de
Introduction:
The study was performed to quantify the benefit of preoxygenated hyperventilated hypocapnic apnea-induced radiation (PHAIR) for breath hold (BH) time in patients with breast cancer.
Methods And Materials:
We compared in a single blind study 6 healthy volunteers and 10 breast cancer patients using PHAIR. Both groups were subdivided into two arms, each including 4min eupnea and hyperventilation with 20 breaths/min to 19-20mmHG FeCO2 before apnea without (hBH) and with 100% oxygen (ohBH). Apnea times were measured with an in-house breathholding device and an adapted ventilator, and blood and respiration gas parameters through our laboratory.
Results:
The experiment was well-tolerated by patients without compromising their security. A significant increase in BH was observed upon hBH and ohBH compared to standard breath hold - up to 700% in ohBH. There is evidence that the patients interrupted their breath hold before the actual physiological end.
Conclusion:
PHAIR is a feasible, safe and recommendable technique that could be used to improve BH for high precision radiotherapy. Further research is necessary to obtain a clinical value for this technique.
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