Brief Summary
This randomized pilot clinical trial studies the effects of meditation-based breathing training on patients' control of their breathing patterns and breathing-related movement, as well as on their psychological distress and treatment experience during radiation therapy. Meditation-based breathing training may decrease breathing-related movement and the amount of stress by improving breathing patterns in patients with abdominal or lung cancer undergoing radiation therapy.
Brief Title
Meditation-Based Breathing Training in Improving Target Motion Management and Reducing Distress in Patients With Abdominal or Lung Cancer Undergoing Radiation Therapy
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate the influence of regular breathing cycles using breathing relaxation techniques on efficacy of the respiratory-gated treatment as measured by: (1) real-time position management (RPM) parameters; (2) end inspiration or expiration length; (3) changes in gate width.
SECONDARY OBJECTIVES:
I. To evaluate the effect of breathing relaxation techniques on: (1) psychosocial outcomes; (2) treatment compliance.
OUTLINE:
PHASE I: Patients and staff members complete structured interviews at baseline.
PHASE II: Patients are randomized to 1 of 2 arms.
ARM I: Patients participate in 3 50-minute breathing training sessions, including a psycho-educational component and meditation-based breathing training, over 10 days. Patients then undergo four dimensional computed tomography (4D-CT) on day 14 and undergo image-guided stereotactic body radiation therapy (SBRT) or standard radiation therapy 5 times a week for up to 5 fractions or 25 fractions, respectively.
ARM II: Patients receive standard care over 10 days. Patients then undergo 4D-CT on day 14 and undergo image-guided SBRT or standard radiation therapy 5 times a week for up to 5 fractions or 25 fractions, respectively.
After completion of study treatment, patients are followed up at 2 or 5 weeks.
I. To evaluate the influence of regular breathing cycles using breathing relaxation techniques on efficacy of the respiratory-gated treatment as measured by: (1) real-time position management (RPM) parameters; (2) end inspiration or expiration length; (3) changes in gate width.
SECONDARY OBJECTIVES:
I. To evaluate the effect of breathing relaxation techniques on: (1) psychosocial outcomes; (2) treatment compliance.
OUTLINE:
PHASE I: Patients and staff members complete structured interviews at baseline.
PHASE II: Patients are randomized to 1 of 2 arms.
ARM I: Patients participate in 3 50-minute breathing training sessions, including a psycho-educational component and meditation-based breathing training, over 10 days. Patients then undergo four dimensional computed tomography (4D-CT) on day 14 and undergo image-guided stereotactic body radiation therapy (SBRT) or standard radiation therapy 5 times a week for up to 5 fractions or 25 fractions, respectively.
ARM II: Patients receive standard care over 10 days. Patients then undergo 4D-CT on day 14 and undergo image-guided SBRT or standard radiation therapy 5 times a week for up to 5 fractions or 25 fractions, respectively.
After completion of study treatment, patients are followed up at 2 or 5 weeks.
Categories
Completion Date
Completion Date Type
Actual
Conditions
Anxiety
Depression
Digestive System Neoplasm
Lung Neoplasm
Pain
Post-Traumatic Stress Disorder
Psychological Impact of Cancer
Eligibility Criteria
Inclusion Criteria:
* PHASE I - PATIENTS: All patients with abdominal tumors who have undergone at least 4 respiratory-gated radiotherapy treatments
* PHASE I - PATIENTS: Full comprehension of English language
* PHASE I - STAFF: All staff who have overseen the delivery of respiratory-gated radiotherapy for at least 6 months
* PHASE I - STAFF: Full comprehension of English language
* PHASE II: All patients with abdominal or lung tumors undergoing a respiratory gating simulation
* PHASE II: Karnofsky performance status \> 60%
* PHASE II: Life expectancy \> 3 months
* PHASE II: No prior radiotherapy to the abdomen/lung
* PHASE II: Full comprehension of English language
Exclusion Criteria:
* PHASE I - PATIENTS: Inability to comprehend English language interview questions
* PHASE I - STAFF: Inability to comprehend English language interview questions
* PHASE II: Karnofsky performance status \< 60%
* PHASE II: Prior radiotherapy to the abdomen/lung
* PHASE II: Evidence of progressive or untreated gross disease outside of the abdomen/lung
* PHASE II: Inability to comprehend English language breathing exercise instructions
* PHASE II: Concurrent diagnosis of a significant respiratory disorder which requires the use of oxygen
* PHASE I - PATIENTS: All patients with abdominal tumors who have undergone at least 4 respiratory-gated radiotherapy treatments
* PHASE I - PATIENTS: Full comprehension of English language
* PHASE I - STAFF: All staff who have overseen the delivery of respiratory-gated radiotherapy for at least 6 months
* PHASE I - STAFF: Full comprehension of English language
* PHASE II: All patients with abdominal or lung tumors undergoing a respiratory gating simulation
* PHASE II: Karnofsky performance status \> 60%
* PHASE II: Life expectancy \> 3 months
* PHASE II: No prior radiotherapy to the abdomen/lung
* PHASE II: Full comprehension of English language
Exclusion Criteria:
* PHASE I - PATIENTS: Inability to comprehend English language interview questions
* PHASE I - STAFF: Inability to comprehend English language interview questions
* PHASE II: Karnofsky performance status \< 60%
* PHASE II: Prior radiotherapy to the abdomen/lung
* PHASE II: Evidence of progressive or untreated gross disease outside of the abdomen/lung
* PHASE II: Inability to comprehend English language breathing exercise instructions
* PHASE II: Concurrent diagnosis of a significant respiratory disorder which requires the use of oxygen
Inclusion Criteria
Inclusion Criteria:
* PHASE I - PATIENTS: All patients with abdominal tumors who have undergone at least 4 respiratory-gated radiotherapy treatments
* PHASE I - PATIENTS: Full comprehension of English language
* PHASE I - STAFF: All staff who have overseen the delivery of respiratory-gated radiotherapy for at least 6 months
* PHASE I - STAFF: Full comprehension of English language
* PHASE II: All patients with abdominal or lung tumors undergoing a respiratory gating simulation
* PHASE II: Karnofsky performance status \> 60%
* PHASE II: Life expectancy \> 3 months
* PHASE II: No prior radiotherapy to the abdomen/lung
* PHASE II: Full comprehension of English language
* PHASE I - PATIENTS: All patients with abdominal tumors who have undergone at least 4 respiratory-gated radiotherapy treatments
* PHASE I - PATIENTS: Full comprehension of English language
* PHASE I - STAFF: All staff who have overseen the delivery of respiratory-gated radiotherapy for at least 6 months
* PHASE I - STAFF: Full comprehension of English language
* PHASE II: All patients with abdominal or lung tumors undergoing a respiratory gating simulation
* PHASE II: Karnofsky performance status \> 60%
* PHASE II: Life expectancy \> 3 months
* PHASE II: No prior radiotherapy to the abdomen/lung
* PHASE II: Full comprehension of English language
Gender
All
Gender Based
false
Healthy Volunteers
No
Last Update Post Date
Last Update Post Date Type
Actual
Last Update Submit Date
Minimum Age
18 Years
NCT Id
NCT01939210
Org Class
Other
Org Full Name
Albert Einstein College of Medicine
Org Study Id
09-12-392
Overall Status
Terminated
Phases
Not Applicable
Primary Completion Date
Primary Completion Date Type
Actual
Official Title
Influence of Meditation-Based Breathing Training on Target Motion Management and Distress During Radiation for Abdominal and Lung Malignancies
Primary Outcomes
Outcome Description
Data will be analyzed using a mixed-model analysis of variance (ANOVA) to test for differences between the two independent groups (with a fixed effect factor of group membership).
Outcome Measure
Change in duty cycle, defined as the fraction of the time of the breathing cycle that the beam is on, before and after breath coaching
Outcome Time Frame
Baseline to up to 5 weeks
Outcome Measure
Changes in gate width
Outcome Time Frame
Baseline to up to 5 weeks
Outcome Description
Data will be analyzed using a mixed-model ANOVA to test for differences between the two independent groups (with a fixed effect factor of group membership).
Outcome Measure
Changes in the length of the end expiration or end inspiration defined as when the breathing trace or internal motion change direction
Outcome Time Frame
Baseline to up to 5 weeks
Secondary Ids
Secondary Id
NCI-2013-01127
Secondary Id
09-068
Secondary Id
09-12-392
Secondary Id
P30CA013330
Secondary Outcomes
Outcome Description
Data will be analyzed using a mixed-model ANOVA to test for differences between the two independent groups (with a fixed effect factor of group membership).
Outcome Time Frame
Baseline to up to 5 weeks
Outcome Measure
Change in patients' self-reported levels of psychological distress, physical pain and discomfort, and post-traumatic stress associated with cancer diagnosis and radiation treatment
Start Date
Status Verified Date
First Post Date
First Post Date Type
Estimated
First Submit Date
First Submit QC Date
Std Ages
Adult
Older Adult
Maximum Age Number (converted to Years and rounded down)
999
Minimum Age Number (converted to Years and rounded down)
18
Investigators
Investigator Type
Principal Investigator
Investigator Name
Alyson Moadel
Investigator Email
alyson.moadel-robblee@einsteinmed.org
Investigator Phone
718-430-2696