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Some caveats of breath hold

2nd patient treated in DIBH

•peripheral target +

mediastinal lymph nodes

•10th fraction: match on

mediastinum, 1.6 cm shift CC

direction for peripheral tumour

CT CBCT

Josipovic et al Acta Oncol 2014

Don’t (blindly) trust external surrogates:

markers, spirometry, surface based etc…

Daily breath hold CBCT is mandatory

Intra fraction monitoring highly desirable