High-dose-rate Three-dimensional Conformal Radiotherapy Combined with Active Breathing Control for Stereotactic Body Radiotherapy of Early-stage Non-small-cell Lung Cancer

Wang, Ruozheng; Yin, Yilong; Qin, Y.; J, Yu

doi:10.7785/tcrt.2012.500441

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…Radiotherapy with ABC has been performed in our hospital for nearly 15 years. Although the ABC device plays an important role in dose escalation for tumors and dose decreases for OARs 8 , 9 , 27 , there are some details that should be given special consideration. Patients should be provided with sufficient time to rest; radiation therapist should choose the right moments to stop rest and start beam-on treatment; the normal shape of the connection pipe should be maintained; the connection pipe should be kept clean and dry (especially the filter); and the tightness of the pipeline should be checked and confirmed 8 , 9 .…”

Section: Discussionmentioning

confidence: 99%

Study of an Oxygen Supply and Oxygen Saturation Monitoring System for Radiation Therapy Associated with the Active Breathing Coordinator

Gong

Guo

Sun

et al. 2018

Sci Rep

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In this study, we designed an oxygen supply and oxygen saturation monitoring (OSOSM) system. This OSOSM system can provide a continuous supply of oxygen and monitor the peripheral capillary oxygen saturation (SpO2) of patients who accept radiotherapy and use an active breathing coordinator (ABC). A clinical test with 27 volunteers was conducted. The volunteers were divided into two groups based on the tendency of SpO2 decline in breath-holding without the OSOSM system: group A (12 cases) showed a decline in SpO2 of less than 2%, whereas the decline in SpO2 in group B (15 cases) was greater than 2% and reached up to 6% in some cases. The SpO2 of most volunteers declined during rest. The breath-holding time of group A without the OSOSM system was significantly longer than that of group B (p < 0.05) and was extended with the OSOSM system by 26.6% and 27.85% in groups A and B, respectively. The SpO2 recovery time was reduced by 36.1%, and the total rest time was reduced by 27.6% for all volunteers using the OSOSM system. In summary, SpO2 declines during breath-holding and rest time cannot be ignored while applying an ABC. This OSOSM system offers a simple and effective way to monitor SpO2 variation and overcome SpO2 decline, thereby lengthening breathholding time and shortening rest time.Breathing motion is a critical factor that affects the accuracy of radiotherapy for thoracic and abdominal cancers; it can induce errors in tumor localization, treatment planning design, patient setup and dose delivery 1 . These errors can result in uncertain doses of radiation to the target tumor volume and organs at risk (OARs), which increases the risks of treatment failure and of radiation injury to OARs. Thus, it is important to solve problems involving breathing motion in the context of thoracoabdominal tumor radiation therapy. Breathing motion management methodologies (e.g., active breathing control, breath gating, and abdominal compression) have played important roles in decreasing the motion effect on radiotherapy precision 2 . Active breathing coordinator TM (ABC; Elekta Oncology, Crawley, UK) is an active breathing control technology that helps patients achieve and maintain their breath-holding status for up to 30 s or even longer through a special pipe. Theoretically, the ABC can eliminate the errors affecting tumor target volume position and the dose delivery induced by the breathing motion, and it has been applied at our radiation oncology clinic for more than 18 years since it was first reported by Wong et al. in 1999 3 . Furthermore, encouraging dosimetric benefits have been obtained via the precise radiation therapy of non-small cell lung cancer (NSCLC), breast cancer, lymphoma and liver cancer [4][5][6][7][8] . Our preliminary work proposed a method that combined volumetric modulated radiation therapy with active breathing control during moderate deep-inspiration breath-holding. We demonstrated that the mean

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Section: Discussionmentioning

confidence: 99%

Study of an Oxygen Supply and Oxygen Saturation Monitoring System for Radiation Therapy Associated with the Active Breathing Coordinator

Gong

Guo

Sun

et al. 2018

Sci Rep

Self Cite

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“…The 48 patients enrolled underwent a planning CT thorax scan (thoracic inlet to below the diaphragm) with intravenous contrast as clinically indicated. The scan was performed in breath-hold with the use of the an active breathing control (ABC) device, 24 or a four-dimensional (4D) scan was acquired in free-breathing if the ABC device was not tolerated. Within a 4 h period, the patient underwent a lung SPECT perfusion scan.…”

Section: Methodsmentioning

confidence: 99%

Spect perfusion imaging versus CT for predicting radiation injury to normal lung in lung cancer patients

Weller

Dunlop

Oxer

et al. 2019

The British Journal of Radiology

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Objectives: In non-small cell lung cancer (NSCLC) patients, to establish whether the fractional volumes of irradiated anatomic or perfused lung differed between those with and without deteriorating lung function or radiation associated lung injury (RALI). Methods: 48 patients undergoing radical radiotherapy for NSCLC had a radiotherapy-planning CT scan and single photon emission CT lung perfusion imaging (99mTc-labelled macroaggregate albumin). CT defined the anatomic and the single photon emission CT scan (co-registered with CT) identified the perfused (threshold 20 % of maximum) lung volumes. Fractional volumes of anatomic and perfused lung receiving more than 5, 10, 13, 20, 30, 40, 50 Gy were compared between patients with deteriorating (>median decline) vs stable (<median decline) forced expiratory volume in 1 s (FEV1) and between those with and without RALI (assessed by Common Toxic Criteria for Adverse Events) radiation pneumonitis and pulmonary fibrosis scores. Results: Fractional volumes of anatomic and perfused lung receiving more than 10, 13 and 20 Gy were significantly higher in patients with deteriorating vs stable FEV1 ( p = 0.005, 0.005 and 0.025 respectively) but did not differ for higher doses of radiation (>30, 40, 50 Gy). Fractional volumes of anatomic and perfused lung receiving > 10 Gy best predicted decline in FEV1 (Area under receiver operating characteristic curve (Az = 0.77 and 0.76 respectively); sensitivity/specificity 75%/81 and 80%/71%) for a 32.7% anatomic and 33.5% perfused volume cut-off. Irradiating an anatomic fractional volume of 4.7% to > 50 Gy had a sensitivity/specificity of 83%/89 % for indicating RALI (Az = 0.83). Conclusion: A 10–20 Gy radiation dose to anatomic or perfused lung results in decline in FEV1. A fractional anatomic volume of >5% receiving >50 Gy influences development of RALI. Advances in knowledge: Extent of low-dose radiation to normal lung influences functional respiratory decline.

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Planning issues on linac-based stereotactic radiotherapy

Huang¹,

Yang²,

Liu³

2022

World J Clin Cases

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High-dose-rate Three-dimensional Conformal Radiotherapy Combined with Active Breathing Control for Stereotactic Body Radiotherapy of Early-stage Non-small-cell Lung Cancer

Abstract: The purpose of this study was to evaluate the feasibility and benefits of using high-dose-rate three-dimensional conformal radiotherapy (3D-CRT) combined with active breathing control

Cited by 3 publications

References 34 publications

Study of an Oxygen Supply and Oxygen Saturation Monitoring System for Radiation Therapy Associated with the Active Breathing Coordinator

Study of an Oxygen Supply and Oxygen Saturation Monitoring System for Radiation Therapy Associated with the Active Breathing Coordinator

Spect perfusion imaging versus CT for predicting radiation injury to normal lung in lung cancer patients

Planning issues on linac-based stereotactic radiotherapy

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