3D-conformal radiotherapy for inoperable non-small-cell lung cancer - A single centre experience

Fromm, Sabine; Rottenfusser, Andrea; Berger, Daniel; Pirker, Robert; Pötter, Richard; Pokrajac, Boris

doi:10.2478/v10019-007-0022-9

Cited by 2 publications

(1 citation statement)

References 25 publications

(42 reference statements)

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“…For patients with oncological and/or functional inoperable non-small-cell lung cancer (NSCLC), three dimensional conformal radiotherapy (3D CRT) has become an established treatment modality (1). Using 3D CRT in the management of lung cancer, it is possible to maximize the tumor dose while simultaneously sparing the organ at risks (OARs) and normal tissues.…”

Section: Introductionmentioning

confidence: 99%

A Study of the Anatomic Changes and Dosimetric Consequences in Adaptive CRT of Non-Small-Cell Lung Cancer Using Deformable CT and CBCT Image Registration

Hou

et al. 2014

Technol Cancer Res Treat

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The aim of this study is to evaluate anatomic lung tumor changes and dosimetric consequences utilizing the deformable daily kilovolt (KV) cone-beam computer tomography (CBCT) image registration. Five patients diagnosed with NSCLC were treated with three-dimensional conformal radiotherapy (3D CRT) and 10 daily KV CBCT image sets were acquired for each patient. Each CBCT image and plan CT were imported into the deformable image registration (DIR) system. The plan CT image was deformed by the DIR system and a new contour on CBCT was obtained by using the auto-contouring function of the DIR. These contours were individually marked as CBCT f1, CBCT f2,…, and CBCT f10, and imported into a treatment planning system (TPS). The daily CBCT plan was individually generated with the same planning criteria based on new contours. These plans were individually marked as CBCTp1, CBCTp2,…, and CBCTp10, followed by generating a dose accumulation plan (DA plan) in original pCT image contour sets by adding all CBCT plans using Varian Eclipse TPS. The maximum, minimum and mean doses to the plan target volume (PTV) in the 5 DA plans were the same with the CT plans. However, the volume of radiation 5, 10, 20, 30, and 50 Gy of the total lungs in DA plans were less than those of the CT plans. The maximum dose of the spinal cord in the DA plans were average 27.96% less than the CT plans. The mean dose for the left, right, and total lungs in the DA plans were reduced by 13.80%, 23.65%, and 12.96%, respectively. The adaptive 3D CRT based on the deformable registration can reduce the dose to the lung and the spinal cord with the same PTV dose coverage. Moreover, it provides a method for further adaptive radiotherapy exploration.

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Section: Introductionmentioning

confidence: 99%

A Study of the Anatomic Changes and Dosimetric Consequences in Adaptive CRT of Non-Small-Cell Lung Cancer Using Deformable CT and CBCT Image Registration

Hou

et al. 2014

Technol Cancer Res Treat

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Importance of four-dimensional computed tomography simulation in locally advanced lung cancer radiotherapy: Impact on reducing planning target volume

Maric¹,

Janjic²,

Bosančić

et al. 2022

VOJNOSANIT PREGL

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Background/Aim. Four dimensional (4DCT) simulation is a useful tool for motion assessment in lung cancer radiotherapy. Conventional Three dimensional (3D) - Free Breathing simulation is static, with limited motion information. The aim of this study was to compare clinically significant differences between the target volumes defined on 3D CT vs. 4D CT simulation and potential impact on the planning target volume (PTV). In addition, to quantify movements of primary tumour (GTV) during 4D CT simulation on three axis -Z-supero inferior (SI), X-mediolateral (ML), and Y-anteroposterior (AP). Methods. This retrospective study evaluated 20 lung cancer patients who underwent CT simulation for radical radiotherapy treatment. Free Breathing 3D CT and 4D CT simulation were acquired for each patient in accordance with our institutional protocol. Volumetric comparison radiation volumes defined on 3D CT vs. 4D CT simulation was done-Gross tumour volume GTV 3D vs. internal GTV- (iGTV 4D) and PTV 3D vs. iPTV 4D. Volumetric values expressed in cm3 and equivalent spherical diameter (ESD) expressed in cm were assessed. Comparison of GTV movement in the phase FB-GTV FB, phase 0-GTV0, phase 50-GTV 50, and phase Maximum intensity projection (MIP) -GTV MIP was made with GTV FB as the basic value. The evaluation was made in three axis. Results. Comparison volumetric values between GTV 3D vs. iGTV 4D was 63.15 vs.85.51 (p<0.001) respectively. iGTV 4D was significantly larger than GTV 3D (p<0.001). The mean value (ESD) PTV 3D vs.iPTV 4D was 8.44 vs. 7.82 (p<0.001) respectively, and mean value volume PTV 3D vs. iPTV 4D was 352.70 vs. 272.78 (p<0.001) respectively. PTV 3D was significantly larger than iPTV 4D (p<0.001). Statistically significant difference (p<0.05) was identified in the deviation related to Z axis between the upper and lower lobe. Conclusion. 4D CT simulation based delineation can reduce planning target volume compared to 3D simulation based radiation therapy and therefore, it is a prerequisite for high-quality and precise radiation therapy treatment.

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3D-conformal radiotherapy for inoperable non-small-cell lung cancer - A single centre experience

Cited by 2 publications

References 25 publications

A Study of the Anatomic Changes and Dosimetric Consequences in Adaptive CRT of Non-Small-Cell Lung Cancer Using Deformable CT and CBCT Image Registration

A Study of the Anatomic Changes and Dosimetric Consequences in Adaptive CRT of Non-Small-Cell Lung Cancer Using Deformable CT and CBCT Image Registration

Importance of four-dimensional computed tomography simulation in locally advanced lung cancer radiotherapy: Impact on reducing planning target volume

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