Improving patient preparation and comfort in voluntary DIBH - Single-centre quality improvement evaluation

Voluntary deep-inspiration breath-hold (vDIBH) is commonly used in left breast cancer patients during radiotherapy to reduce cardiac dose and improve setup accuracy. However, some patients have trouble maintaining a consistent, adequate, breath-hold during radiotherapy. This service evaluation assessed the impact of the RESPIRE tool-an online resource offering instructional videos and audio guides-introduced prior to simulation to improve patient compliance and preparedness.

Fifteen eligible breast cancer patients received RESPIRE information during a clinic appointment for Radiotherapy consent, followed by a telephone check-in prior to CT planning. Breath-hold quality was assessed using planning CT metrics and treatment-image reproducibility, and patient experience was qualitatively evaluated.

Compared to historical controls, the fifteen RESPIRE users reported feeling significantly more prepared, and blinded reviews of CBCT images confirmed improved breath-hold reproducibility. Lung volume increased by an average of 32 %, and heart-to-chest wall separation improved following use of the tool.

The results align with existing evidence that guided preparation reduces anxiety and supports successful vDIBH implementation. The intervention addresses current ESTRO-ACROP and national safety priorities by promoting patient engagement, comfort, and technical accuracy.

Pre-treatment education using scalable tools like RESPIRE offers a low-cost, high-impact strategy to enhance radiotherapy outcomes and patient-centred care. Future work could hope to make this tool accessible to a wider cohort of patients, addressing some of the limitations discussed.