Does intensity modulation increase target dose calculation errors of conventional algorithms for lung <scp>SBRT</scp>?

Zheng, Dandan; Verma, Vivek; Wang, Shuo; Liang, Xiaoying; Zhou, Sumin

doi:10.1002/acm2.12266

Cited by 3 publications

(2 citation statements)

References 25 publications

(90 reference statements)

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“…Another limitation is that a variety of dose algorithms were used for the retrospective cohort with varying levels of calculation accuracy especially in terms of heterogeneity corrections. Of them, Pinnacle CCC and Eclipse AAA are known to be more accurate than iPlan PBC, although our previous studies have found that the dose differences among the algorithms are mostly seen for the target especially at the target periphery and much less so for the OARs especially in the low dose regions [35]. Nevertheless, not accounting for the different dose algorithms could introduce additional uncertainty in our results.…”

Section: In the Appendix)mentioning

confidence: 79%

Correlation of dosimetric factors with the development of symptomatic radiation pneumonitis in stereotactic body radiotherapy

et al. 2020

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Background: The development of radiation pneumonitis (RP) after Stereotactic Body Radiotherapy (SBRT) is known to be associated with many different factors, although historical analyses of RP have commonly utilized heterogeneous fractionation schemes and methods of reporting. This study aims to correlate dosimetric values and their association with the development of Symptomatic RP according to recent reporting standards as recommended by the American Association of Physicists in Medicine. Methods: We performed a single-institution retrospective review for patients who received SBRT to the lung from 2010 to 2017. Inclusion criteria required near-homogeneous tumoricidal (α/β = 10 Gy) biological effective dose (BED10) of 100-105 Gy (e.g., 50/5, 48/4, 60/8), one or two synchronously treated lesions, and at least 6 months of follow up or documented evidence of pneumonitis. Symptomatic RP was determined clinically by treating radiation oncologists, requiring radiographic evidence and the administration of steroids. Dosimetric parameters and patient factors were recorded. Lung volumes subtracted gross tumor volume(s). Wilcoxon Rank Sums tests were used for nonparametric comparison of dosimetric data between patients with and without RP; p-values were Bonferroni adjusted when applicable. Logistic regressions were conducted to predict probabilities of symptomatic RP using univariable models for each radiation dosimetric parameter. Results: The final cohort included 103 treated lesions in 93 patients, eight of whom developed symptomatic RP (n = 8; 8.6%). The use of total mean lung dose (MLD) > 6 Gy alone captured five of the eight patients who developed symptomatic RP, while V20 > 10% captured two patients, both of whom demonstrated a MLD > 6 Gy. The remaining three patients who developed symptomatic RP without exceeding either metric were noted to have imaging evidence of moderate interstitial lung disease, inflammation of the lungs from recent concurrent chemoradiation therapy to the contralateral lung, or unique peri-tumoral inflammatory appearance at baseline before treatment. Conclusions: This study is the largest dosimetric analysis of symptomatic RP in the literature, of which we are aware, that utilizes near-homogenous tumoricidal BED fractionation schemes. Mean lung dose and V20 are the most consistently reported of the various dosimetric parameters associated with symptomatic RP. MLD should be considered alongside V20 in the treatment planning process. Trial registration: Retrospectively registered on IRB 398-17-EP.

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Section: In the Appendix)mentioning

confidence: 79%

Correlation of dosimetric factors with the development of symptomatic radiation pneumonitis in stereotactic body radiotherapy

et al. 2020

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“…Therefore, the dose calculation results of kV-CBCT in this study are reliable. For MV beams, several studies 26,27 confirmed that there was no significant difference between the lung dose distribution calculated by CCC algorithm and that simulated by MC code.…”

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confidence: 93%

Evaluation of IGRT-Induced Imaging Doses and Secondary Cancer Risk for SBRT Early Lung Cancer Patients In Silico Study

Duan

Yang³

et al. 2021

Technol Cancer Res Treat

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Objectives: This study performed dosimetry studies and secondary cancer risk assessments on using electronic portal imaging device (EPID) and cone beam computed tomography (CBCT) as image guided tools for the early lung cancer patients treated with SBRT. Methods: The imaging doses from MV-EPID and kV-CBCT of the Edge accelerator were retrospectively added to sixty-one SBRT treatment plans of early lung cancer patients. The MV-EPID imaging dose (6MV Photon beam) was calculated in Pinnacle TPS, and the kV-CBCT imaging dose was simulated and calculated by modeling of the kV energy beam in TPS using Pinnacle automatic modeling program. Three types of plans, namely PlanEPID, PlanCBCT and Planorigin, were generated with incorporating doses of EPID, CBCT and no imaging, respectively, for analysis. The effects of imaging doses on dose-volume-histogram (DVH) and plan quality were analyzed, and the excess absolute risk (EAR) of secondary cancer for ipsilateral lung was evaluated. Results: The regions that received less than 50 cGy were significantly impacted by the imaging doses, while the isodose lines greater than 1000 cGy were barely changed. The DVH values of ipsilateral lung increased the most in PlanEPID, followed by PlanCBCT. Compared to Planorigin on the average, the estimated EAR of ipsilateral lung in PlanEPID increased by 3.43%, while the corresponding EAR increase in PlanCBCT was much smaller (about 0.4%). Considering only the contribution of the imaging dose, the EAR values for the ipsilateral lung due to the MV-EPID dose in 5 years,10 years and 15 years were 1.49 cases, 2.09 cases and 2.88 cases per 104PY respectively, and those due to the kV-CBCT dose were about 9 times lower, correspondingly. Conclusions: The imaging doses produced by MV-EPID and kV-CBCT had little effects on the target dose coverage. The secondary cancer risk caused by MV-EPID dose is more than 8.5 times that of kV-CBCT.

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Dosimetric benefits of dynamic conformal arc therapy-combined with active breath-hold in lung stereotactic body radiotherapy

Lee

Verma

et al. 2022

Medical Dosimetry

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Does intensity modulation increase target dose calculation errors of conventional algorithms for lung SBRT?

Cited by 3 publications

References 25 publications

Correlation of dosimetric factors with the development of symptomatic radiation pneumonitis in stereotactic body radiotherapy

Correlation of dosimetric factors with the development of symptomatic radiation pneumonitis in stereotactic body radiotherapy

Evaluation of IGRT-Induced Imaging Doses and Secondary Cancer Risk for SBRT Early Lung Cancer Patients In Silico Study

Dosimetric benefits of dynamic conformal arc therapy-combined with active breath-hold in lung stereotactic body radiotherapy

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