Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

A feasibility study of relaxation therapy plus autohypnotherapy training (HYPREL)for patients with thoracic cancer undergoing radiotherapy. (#523)

Emma J Lewis 1 , Rachel Barton , Julie S Bateman , Andy Beavis , Fiona Braid , Mohammad Butt , Amulya Chaturvedi , Kay Duxbery , Andrew Greenhalgh , Claire Hebblewhite , Teresa A Hope , Claire Hutton , Michael G Lines , Mark J Stein , Martin Sykes , Lorcan O'Toole , Mary B Walker , Andrzej Wieczorek , Donald M Sharp , Leslie G Walker
  1. Hull and East yorkshire Hospitals NHS Trust, Cottingham, United Kingdom

As radiotherapy becomes more sophisticated, it is becoming increasingly important to minimise respiratory movement during radiotherapy planning (CT simulation) and treatment. Psychological factors such as procedure-related anxiety and pain may affect respiratory parameters2 4 6 5, resulting in sub-optimal planning and radiotherapy.

The aims of this study were to develop a psychological intervention that would minimise respiratory changes associated with procedure-related anxiety during planning and radiotherapy, and to carry out a preliminary evaluation of the effects of the intervention on respiration and quality of life during planning and radiotherapy.

The planned accrual target of 30 patients was reached with 31 patients randomised to the experimental intervention (HYPREL -relaxation, autohypnotherapy and exposure in vivo) or to the control group.

The primary outcome, respiratory amplitude during radiotherapy planning, was assessed objectively and repeatedly using the Varian RPM system. Secondary respiratory outcomes - amplitude variability, frequency, and frequency variability - were assessed during radiotherapy planning. Respiratory parameters were assessed repeatedly during the course of radiotherapy, and quality of life was assessed on six occasions during the study139  .

Compared to the control group, patients randomised to HYPREL had a lower mean amplitude of respiration during radiotherapy planning (ANOVA, F = 3.905, p=0.059). There were no significant differences in amplitude variability, respiration frequency, or frequency variability.

The two groups did not differ on any of the respiratory or quality of life parameters during the course of radiotherapy. This pilot study has demonstrated that HYPREL is an acceptable intervention for patients undergoing radiotherapy to the chest wall, and there is some evidence that HYPREL reduces the amplitude of respiration during radiotherapy planning, thereby potentially minimising unnecessary radiotherapy-induced damage to tissue surrounding the tumour.

In conclusion, the data from this preliminary study show that the intervention is feasible, and provides the justification for a larger, adequately powered, randomised controlled trial.

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