The effect on minimum tumor dose of restricting target-dose inhomogeneity in optimized three-dimensional treatment of lung cancer

Langer, Márk; Kijewski, Peter K.; Brown, Richard; Ha, Chul S.

doi:10.1016/0167-8140(91)90049-m

Cited by 26 publications

(8 citation statements)

References 22 publications

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“…A similar effect on minimum tumor dose can be seen when the dose homogeneity limit for the target is varied. 50 The small variations in the dose specifications that induce these large changes in minimum tumor dose fall well within the range of uncertainty in current estimates of the dose distributions. The tolerance limits themselves can become better refined by allowing better correlations between dose and adverse events in large scale clinical trials, a research topic which would benefit from improved support.…”

Section: A How Will Improved Accuracy Be Used By the Clinic?mentioning

confidence: 53%

Summary and recommendations of a National Cancer Institute workshop on issues limiting the clinical use of Monte Carlo dose calculation algorithms for megavoltage external beam radiation therapy

2003

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Due to the significant interest in Monte Carlo dose calculations for external beam megavoltage radiation therapy from both the research and commercial communities, a workshop was held in October 2001 to assess the status of this computational method with regard to use for clinical treatment planning. The Radiation Research Program of the National Cancer Institute, in conjunction with the Nuclear Data and Analysis Group at the Oak Ridge National Laboratory, gathered a group of experts in clinical radiation therapy treatment planning and Monte Carlo dose calculations, and examined issues involved in clinical implementation of Monte Carlo dose calculation methods in clinical radiotherapy. The workshop examined the current status of Monte Carlo algorithms, the rationale for using Monte Carlo, algorithmic concerns, clinical issues, and verification methodologies. Based on these discussions, the workshop developed recommendations for future NCI-funded research and development efforts. This paper briefly summarizes the issues presented at the workshop and the recommendations developed by the group.

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Section: A How Will Improved Accuracy Be Used By the Clinic?mentioning

confidence: 53%

Summary and recommendations of a National Cancer Institute workshop on issues limiting the clinical use of Monte Carlo dose calculation algorithms for megavoltage external beam radiation therapy

2003

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“…A minimum tumor dose of Ͼ80 Gy could be delivered in all six cases examined when an inhomogeneity limit of 20% was accepted, but the minimum tumor dose fell to the range 44 -64 Gy when the limit was tightened to 13%-17%. 125 An example of the differences that can be seen in the sensitivity of tumor dose to various tissue limits is shown in Fig. 8 for a hypothetical model.…”

Section: Mark Langermentioning

confidence: 99%

Methodological issues in radiation dose–volume outcome analyses: Summary of a joint AAPM/NIH workshop

et al. 2002

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This report represents a summary of presentations at a joint workshop of the National Institutes of Health and the American Association of Physicists in Medicine (AAPM). Current methodological issues in dose-volume modeling are addressed here from several different perspectives. Areas of emphasis include (a) basic modeling issues including the equivalent uniform dose framework and the bootstrap method, (b) issues in the valid use of statistics, including the need for meta-analysis, (c) issues in dealing with organ deformation and its effects on treatment response, (d) evidence for volume effects for rectal complications, (e) the use of volume effect data in liver and lung as a basis for dose escalation studies, and (f) implications of uncertainties in volume effect knowledge on optimized treatment planning. Taken together, these approaches to studying volume effects describe many implications for the development and use of this information in radiation oncology practice. Areas of significant interest for further research include the meta-analysis of clinical data; interinstitutional pooled data analyses of volume effects; analyses of the uncertainties in outcome prediction models, minimal parameter number outcome models for ranking treatment plans (e.g., equivalent uniform dose); incorporation of the effect of motion in the outcome prediction; dose-escalation/isorisk protocols based on outcome models; the use of functional imaging to study radioresponse; and the need for further small animal tumor control probability/normal tissue complication probability studies.

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“…Unfortunately, the external radiation dose cannot generally exceed 60 Gy due to the tolerance limits of normal lung tissue. However, 60 Gy is a dose that is not sufficient for tumor eradication ( 14 ). The pulmonary volume of the patients was reduced following the operation, resulting in poor pulmonary function.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of 125I seed implantation in the treatment of non‑small cell lung cancer during R2 resection

Zheng

et al. 2017

Oncol Lett

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The aim of the present study was to investigate the effectiveness of 125I particle implantation during R2resection for non-small cell lung cancer (NSCLC). Data from 23 patients with NSCLC and macroscopic residual diseasefollowing surgery (R2 resection) between March 2010 and May 2014 were retrospectively analyzed. Among these patients, 12 patients [4 with T-residual disease (incomplete resection of primary tumor but complete dissection of regional lymph node), 8 with N-residual disease (complete resection of primary tumor but incomplete resection of metastatic regional lymph node)] underwent 125I particle implantation during the operation, while the other 11 (4 with T-residual disease and 7 with N-residual disease) received postoperative conventional radiotherapy. The local control rate, overall survival, and distant metastasis were evaluated. Additionally, the efficacy and safety of brachytherapy using 125I particle implantation during surgery for locally advanced NSCLC were investigated. The 23 patients were followed up for 3–40 months. For the 125I group, the 2-year local control rate was 100%, and the median survival time was 24 months. The 1–2-year survival rates were 83.3 and 58.33%, respectively. For the postoperative radiotherapy group, the median survival time was 12 months, andthe 1- and 2-year survival rates were 54.5 and 27.7%, respectively. No statistically significant difference in 2-year survival rates was detected between the two treatment groups, but the particle implantation group exhibited a higher survival rate trend. For patients with T-residual disease, the survival rate was higher for the 125I seed implantation group compared with the postoperative radiotherapy group. However, there was no significant difference in the rates of metastasis between the two groups for patients with N-residual disease. Therefore, intraoperative implantation of 125I particles during R2 resection of NSCLC may be a safer and more reliable method to reduce the local recurrence rate compared with conventional radiotherapy. Although not statistically significant, the overall survival rate of patients in the 125I seed implantation group was higher compared with the postoperative radiotherapy group.

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The effect on minimum tumor dose of restricting target-dose inhomogeneity in optimized three-dimensional treatment of lung cancer

Cited by 26 publications

References 22 publications

Summary and recommendations of a National Cancer Institute workshop on issues limiting the clinical use of Monte Carlo dose calculation algorithms for megavoltage external beam radiation therapy

Summary and recommendations of a National Cancer Institute workshop on issues limiting the clinical use of Monte Carlo dose calculation algorithms for megavoltage external beam radiation therapy

Methodological issues in radiation dose–volume outcome analyses: Summary of a joint AAPM/NIH workshop

Effectiveness of 125I seed implantation in the treatment of non‑small cell lung cancer during R2 resection

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