meditation-based breathing training in improving target motion management and reducing distress in patients with abdominal or lung cancer undergoing radiation therapy

Conditions: Anxiety; Depression; Digestive System Neoplasm; Lung Neoplasm; Pain; Post-Traumatic Stress Disorder; Psychological Impact of Cancer

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.

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.

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