Difference in target definition using three different methods to include respiratory motion in radiotherapy of lung cancer

Møller, D.S.; Knap, M.M.; Nyeng, T.B.; Khalil, Azza Ahmed; Holt, Marianne Ingerslev; Kandi, M.; Hoffmann, Lone

doi:10.1080/0284186x.2017.1373848

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…Compared to 3D-RT, IMRT allows for better sparing of the surrounding normal tissues [ 16 , 17 ]. Moreover, the use of a 4D-CT for each patient to incorporate the respiratory motion allows to minimize the PTV, leading to a reduction in the dose received by organs at risk [ 18 ]. This dosimetric benefit is likely to translate to a decrease in toxicity [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Optimized radiotherapy to improve clinical outcomes for locally advanced lung cancer

et al. 2018

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BackgroundWe aimed to evaluate the toxicity, loco-regional control (LRC) and overall survival (OS) associated with accelerated intensity-modulated radiotherapy (IMRT) for locally advanced lung cancer.MethodsSeventy-three patients were consecutively treated with IMRT from November 2011 to August 2016. A total dose of 66 Gy was delivered using two different schedules of radiotherapy: simultaneous modulated accelerated radiotherapy (SMART) (30 × 2.2 Gy, across 6 weeks) with or without chemotherapy, or moderate hypofractionated radiotherapy (HRT) (24 × 2.75 Gy, across 4 weeks) in patients unfit to receive concomitant chemotherapy. Data on esophageal and pulmonary toxicities, LRC and OS were prospectively collected.ResultsThe median follow-up duration was 44 months. Severe pneumonitis and esophagitis (grade 3–4) were observed in 7% and 1% of patients respectively, with only one case of grade 4 (pneumonitis). Overall, the 1-year and 2-year LRCs were 76% [95 confidence interval (CI)%: 66–87%] and 62% [95 CI%: 49–77%] respectively. The 1 and 2-year OS rates were 72% [95% CI: 63–83%] and 54% [95 CI%: 43–68%] respectively. None parameters were correlated with LRC or OS. In particular, no difference was observed between patients treated with SMART and H-RT (p = 0.26 and 0.6 respectively), with a 1-year LRC of 74% [95 CI%: 62–86%] for SMART and 91% [95 CI%: 74–100%] for H-RT. No significant differences were observed in the toxicity rates associated with each of the RT schedules.ConclusionsAccelerated IMRT for locally advanced lung cancer is associated with low toxicities and high LRC. Moderate hypofractionated RT, by decreasing the total treatment time, may be promising in improving clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Optimized radiotherapy to improve clinical outcomes for locally advanced lung cancer

et al. 2018

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“…Additionally, CTVtotal and spinal cord were deformably propagated (Eclipse, Varian Medical Systems) to all phases in the 4DCT scan, followed by a manual correction by an experienced oncologist (HM). CTVtotal on all phases was subsequently accumulated into iCTVtotal [26][27]. Target and OARs were delineated in a similar way on the sCT.…”

Section: Patients Target Definition and Imagesmentioning

confidence: 99%

Treatment planning comparison in the PROTECT-trial randomising proton versus photon beam therapy in oesophageal cancer: Results from eight European centres

Hoffmann

Mortensen

Shamshad

et al. 2022

Radiotherapy and Oncology

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“…The major challenge when delivering SBRT to lung metastases is to manage respiratory motion of both tumor and normal tissues. Breathing control strategies such as breath-hold, gating, tumor tracking and motion management techniques have been implemented to deal with this challenge [14,15]. One of those strategies is the Cyberknife® synchrony (Accuray Inc., Sunnyvale, CA), which performs real-time tumor tracking.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases

et al. 2020

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Background: Our aim is to report treatment efficacy and toxicity of patients treated by robotic (Cyberknife®) stereotactic body radiotherapy (SBRT) for oligorecurrent lung metastases (ORLM). Additionally we wanted to evaluate influence of tumor, patient and treatment related parameters on local control (LC), lung and distant progression free-(lung PFS/Di-PFS) and overall survival (OS). Methods: Consecutive patients with up to 5 ORLM (confirmed by FDG PET/CT) were included in this study. Intended dose was 60Gy in 3 fractions (prescribed to the 80% isodose volume). Patients were followed at regular intervals and tumor control and toxicity was prospectively scored. Tumor, patient and treatment data were analysed using competing risk-and Cox regression. Results: Between May 2010 and March 2016, 104 patients with 132 lesions were irradiated from primary lung carcinoma (47%), gastro-intestinal (34%) and mixed primary histologies (19%). The mean tumor volume was 7.9 cc. After a median follow up of 22 months, the 1, 2 and 3 year LC rate (per lesion) was 89.3, 80.0 and 77.8% respectively. The corresponding (per patient) 1, 2 and 3 years lung PFS were 66.3, 50.0, 42.6%, Di-PFS were 80.5, 64.4, 60.6% and OS rates were 92.2, 80.9 and 72.0% respectively. On univariable analysis, gastro-intestinal (GI) as primary tumor site showed a significant superior local control versus the other primary tumor sites. For OS, significant variables were primary histology and primary tumor site with a superior OS for patients with metastases of primary GI origin. LC was significantly affected by the tumor volume, physical and biologically effective dose coverage. Significant variables in multivariable analysis were BED prescription dose for LC and GI as primary site for OS. The vast majority of patients developed no toxicity or grade 1 acute and late toxicity. Acute and late grade 3 radiation pneumonitis (RP) was observed in 1 and 2 patients respectively. One patient with a centrally located lesion developed grade 4 RP and died due to possible RT-induced pulmonary hemorrhage. Conclusions: SBRT is a highly effective local therapy for oligorecurrent lung metastases and could achieve long term survival in patients with favourable prognostic features.

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Difference in target definition using three different methods to include respiratory motion in radiotherapy of lung cancer

Cited by 9 publications

References 27 publications

Optimized radiotherapy to improve clinical outcomes for locally advanced lung cancer

Optimized radiotherapy to improve clinical outcomes for locally advanced lung cancer

Treatment planning comparison in the PROTECT-trial randomising proton versus photon beam therapy in oesophageal cancer: Results from eight European centres

Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases

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