Held-breath self-gating technique for radiotherapy of non–small-cell lung cancer: A feasibility study

Kim, David J.W; Murray, B.; Halperin, Ross; Roa, Wilson

doi:10.1016/s0360-3016(00)01372-9

Cited by 103 publications

(59 citation statements)

References 12 publications

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“…Tumour motion can be unrestricted and monitored, with delivery of RT gated to a pre-defined phase of the respiratory cycle [13][14][15] or following the moving tumour [16]. Alternatively motion can be Brock 5 minimized by planning and treating in passive [17][18][19][20][21] or active [22,23] breathhold.…”

Section: Introductionmentioning

confidence: 99%

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Brock

McNair

Panakis

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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Section: Introductionmentioning

confidence: 99%

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Brock

McNair

Panakis

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…For example, in abdominal cancer patients inhale BH is being used on a daily base in many clinics [10,14]. For inhale BHs, the position variation between consecutive BHs within one fraction has been reported to be up to 7.0 mm for the diaphragm [7] and 2.5 mm for pancreatic tumors [10]. Organ motion during inhale BHs has only been investigated for lung cancer patients; studies have reported motion magnitudes during inhale BHs of up to approximately 5.4 mm for the diaphragm and 3.8 mm for lung tumors [7,8].…”

mentioning

confidence: 99%

“…To eliminate respiratory-induced tumor motion, breathholding (BH) techniques, either at exhale or at inhale, are widely used for a variety of clinical applications [7][8][9][10][11][12][13][14]. For example, inhale BH is often used for breast cancer patients to increase the distance between the heart and the planning target volume [13].…”

mentioning

confidence: 99%

Considerable pancreatic tumor motion during breath-holding

et al. 2016

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Background: Breath-holding (BH) is often used to reduce abdominal organ motion during radiotherapy. However, for inhale BH, abdominal tumor motion during BH has not yet been investigated. The aim of this study was to quantify tumor motion during inhale BH and tumor position variations between consecutive inhale BHs in pancreatic cancer patients. Material and methods: Twelve patients with intratumoral fiducials were included and asked to perform three consecutive 30-second inhale BHs on each of three measurement days. During BH, lateral fluoroscopic movies were obtained and a two-dimensional (2D) image correlation algorithm was used to track the fiducials and the diaphragm, yielding the tumor and diaphragm motion during each BH. The tumor position variation between consecutive BHs was obtained from the difference in initial tumor position between consecutive BHs on a single measurement day. Results: We observed tumor motion during BH with a mean absolute maximum displacement over all BHs of 4.2 mm (range 1.0-11.0 mm) in inferior-superior (IS) direction and 2.7 mm (range 0.5-8.0 mm) in anterior-posterior (AP) direction. We found only a moderate correlation between tumor and diaphragm motion in the IS direction (Pearson's correlation coefficient jrj>0.6 in 45 of 76 BHs). The mean tumor position variation between consecutive BHs was 0.2 [standard deviation (SD) 1.7] mm in the inferior direction and 0.5 (SD 0.8) mm in the anterior direction. Conclusion: We observed substantial pancreatic tumor motion during BH as well as considerable position variation between consecutive BHs on a single day. We recommend further quantifying these uncertainties before introducing breath-hold during radiation treatment of pancreatic cancer patients. Also, the diaphragm cannot be used as a surrogate for pancreatic tumor motion.

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“…35 Respiratory motion management strategies include breath-holding maneuver, realtime tumor tracking technique commonly used in Cyberknife system, and respiration gating extensively seen in linear accelerator system. 36,37 As strongly suggested in RTOG 1112 trial, the breath control mode of vDEBH assisted with RPM is more reproducible than inhale, hence used for patients with liver cancer in this study. This breath-holding technique becomes more viable with the use of faster delivery VMAT technique, which reduced delivery time and potentially increases the feasibility of the clinical utility of breath-hold techniques during treatment.…”

Section: Discussionmentioning

confidence: 98%

The Feasibility and Efficiency of Volumetric Modulated Arc Therapy-Based Breath Control Stereotactic Body Radiotherapy for Liver Tumors

Qiu

Zhang

et al. 2016

Technol Cancer Res Treat

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There are strong evidences showing the promising oncologic results of stereotactic body radiotherapy for liver tumors. This study aims to investigate the feasibility, plan quality, and delivery efficiency of image-guided volumetric modulated arc therapybased voluntary deep exhale breath-holding technique in the stereotactic body radiotherapy for liver tumors. Treatment was planned using volumetric modulated arc therapy with 2 modified partial arc and replanned using intensity modulated radiation therapy technique for comparison. Dosimetric parameters were calculated for plan quality assessment. Quality assurance studies included both point and multiple planar dose verifications. Daily cone beam computed tomography imaging was used to measure and correct positional errors for target volumes and critical structures immediately prior to and during treatment delivery. Total monitor units and delivery times were also evaluated. No significant dosimetric difference was found between volumetricmodulated arc therapy and conventional intensity modulated radiation therapy plans. Both techniques were able to minimize doses to organs at risk including normal liver, kidneys, spinal cord, and stomach. However, the average monitor units with volumetric-modulated arc therapy were significantly lower (29.2%) than those with intensity modulated radiation therapy (P ¼ .012). The average beam-on time in volumetric-modulated arc therapy plans was 22.2% shorter than that in intensity modulated radiation therapy plans. In conclusion, it is feasible to utilize volumetric modulated arc therapy in the treatment planning of stereotactic body radiotherapy for liver tumors under breath control mode. In comparison to conventional intensity modulated radiation therapy plans, volumetric modulated arc therapy plans are of high efficiency with less monitor units, shorter beam-on time, tolerable intrafractional errors as well as better dosimetrics, meriting further investigations, and clinical evaluations.

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Held-breath self-gating technique for radiotherapy of non–small-cell lung cancer: A feasibility study

Cited by 103 publications

References 12 publications

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

The Use of the Active Breathing Coordinator Throughout Radical Non–Small-Cell Lung Cancer (NSCLC) Radiotherapy

Considerable pancreatic tumor motion during breath-holding

The Feasibility and Efficiency of Volumetric Modulated Arc Therapy-Based Breath Control Stereotactic Body Radiotherapy for Liver Tumors

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