Analysis of Changes in Dose Distribution due to Respiration in Stereotactic Body Radiation Therapy (SBRT) for Central Lung Tumors Abutting the Hilar Regions using 4D-CT and Evaluation of the Long-term Clinical Outcomes

2018 ◽  
Vol 102 (3) ◽  
pp. e672
Author(s):  
F. Baba ◽  
Y. Shibamoto ◽  
M. Iwana ◽  
K. Nomura ◽  
J. Nagayoshi
Keyword(s):  
Radiation Therapy ◽  
Clinical Outcomes ◽  
Dose Distribution ◽  
Stereotactic Body Radiation Therapy ◽  
Lung Tumors ◽  
4D Ct ◽  
Stereotactic Body Radiation

Analysis of Dose Distribution and Risk of Pneumonitis in Stereotactic Body Radiation Therapy for Centrally Located Lung Tumors

2015 ◽  
Vol 14 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Danita Kannarunimit ◽  
Martina Descovich ◽  
Aaron Garcia ◽  
Josephine Chen ◽  
Vivian Weinberg ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Dose Distribution ◽  
Stereotactic Body Radiation Therapy ◽  
Lung Tumors ◽  
Stereotactic Body Radiation

scholarly journals GTV volume estimation using different mode of computer tomography for lung tumors in stereotactic body radiation therapy

2019 ◽  
Vol 25 (1) ◽  
pp. 29-34
Author(s):  
Ramaa Lingaiah ◽  
Md Abbas Ali ◽  
Ummay Kulsum ◽  
Muhtasim Aziz Muneem ◽  
Karthick Raj Mani ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Lung Tumors ◽  
Planning System ◽  
Treatment Planning System ◽  
Ct Scans ◽  
4D Ct ◽  
Stereotactic Body Radiation ◽  
Varian Medical System ◽  
Helical Scan

Abstract Aim: To estimate the Gross Tumor Volume (GTV) using different modes (axial, helical, slow, KV-CBCT & 4D-CT) of computed tomography (CT) in pulmonary tumors. Materials & Methods: We have retrospectively included ten previously treated case of carcinoma of primary lung or metastatic lung using Stereotactic Body Radiation Therapy (SBRT) in this study. All the patients underwent 4 modes of CT scan Axial, Helical, Slow & 4D-CT using GE discovery 16 Slice PET-CT scanner and daily KV-CBCT for the daily treatment verification. For standardization, all the patients underwent different modes of scan using 2.5 mm slice thickness, 16 detectors rows and field of view of 400mm. Slow CT was performed using axial mode scan by increasing the CT tube rotation time (typically 3 – 4 sec.) as per the breathing period of the patients. 4D-CT scans were performed and the entire respiratory cycle was divided into ten phases. Maximum Intensity Projections (MIP), Minimum Intensity Projections (MinIP) and Average Intensity Projections (AvIP) were derived from the 10 phases. GTV volumes were delineated for all the patients in all the scanning modes (GTVAX - Axial, GTVHL - Helical, GTVSL – Slow, GTVMIP -4DCT and GTVCB – KV-CBCT) in the Eclipse treatment planning system version 11.0 (M/S Varian Medical System, USA). GTV volumes were measured, documented and compared with the different modes of CT scans. Results: The mean ± standard deviation (range) for MIP, slow, axial, helical & CBCT were 36.5 ± 40.5 (2.29 – 87.0), 35.38 ± 39.52 (2.1 – 82), 31.95 ± 37.29 (1.32 – 66.9), 28.98 ± 33.36 (1.01 – 65.9) & 37.16 ± 42.23 (2.29 – 92). Overall underestimation of helical scan and axial scan compared to MIP is 21% and 12.5%. CBCT and slow CT volume has a good correlation with the MIP volume. Conclusion: For SBRT in lung tumors better to avoid axial and helical scan for target delineation. MIP is a still a golden standard for the ITV delineation, but in the absence of 4DCT scanner, Slow CT and KV-CBCT data may be considered for ITV delineation with caution.

scholarly journals Exceeding Radiation Dose to Volume Parameters for the Proximal Airways with Stereotactic Body Radiation Therapy Is More Likely for Ultracentral Lung Tumors and Associated with Worse Outcome

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3463
Author(s):  
Mark Farrugia ◽  
Sung Jun Ma ◽  
Mark Hennon ◽  
Chukwumere Nwogu ◽  
Elisabeth Dexter ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Propensity Score ◽  
Stereotactic Body Radiation Therapy ◽  
Performance Status ◽  
Bronchial Tree ◽  
Lung Tumors ◽  
Gender Performance ◽  
Dose Fractionation ◽  
Stereotactic Body Radiation ◽  
History Of

The preferred radiotherapeutic approach for central (CLT) and ultracentral (UCLT) lung tumors is unclear. We assessed the toxicity and outcomes of patients with CLT and UCLT who underwent definitive five-fraction stereotactic body radiation therapy (SBRT). We reviewed the charts of patients with either CLT or UCLT managed with SBRT from June 2010–April 2019. CLT were defined as gross tumor volume (GTV) within 2 cm of either the proximal bronchial tree, trachea, mediastinum, aorta, or spinal cord. UCLT were defined as GTV abutting any of these structures. Propensity score matching was performed for gender, performance status, and history of prior lung cancer. Within this cohort of 83 patients, 43 (51.8%) patients had UCLT. The median patient age was 73.1 years with a median follow up of 29.9 months. The two most common dose fractionation schemes were 5000 cGy (44.6%) and 5500 cGy (42.2%) in five fractions. Multivariate analysis revealed UCLT to be associated with worse overall survival (OS) (HR = 1.9, p = 0.02) but not time to progression (TTP). Using propensity score match pairing, UCLT correlated with reduced non-cancer associated survival (p = 0.049) and OS (p = 0.03), but not TTP. Within the matched cohort, dosimetric study found exceeding a D4cc of 18 Gy to either the proximal bronchus (HR = 3.9, p = 0.007) or trachea (HR = 4.0, p = 0.02) was correlated with worse non-cancer associated survival. In patients undergoing five fraction SBRT, UCLT location was associated with worse non-cancer associated survival and OS, which could be secondary to excessive D4cc dose to the proximal airways.

Long-term safety and efficacy of stereotactic body radiation therapy for hepatic oligometastases

2016 ◽  
Vol 6 (2) ◽  
pp. 86-95 ◽  
Author(s):  
Benjamin D. Goodman ◽  
Edward M. Mannina ◽  
Sandra K. Althouse ◽  
Mary A. Maluccio ◽  
Higinia R. Cárdenes
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Safety And Efficacy ◽  
Stereotactic Body Radiation

scholarly journals Upfront Chemotherapy Followed by Stereotactic Body Radiation Therapy with or without Surgery in Older Patients with Localized Pancreatic Cancer: A Single Institution Experience and Review of the Literature

2022 ◽  
Vol 29 (1) ◽  
pp. 308-320
Author(s):  
Abhinav V. Reddy ◽  
Shuchi Sehgal ◽  
Colin S. Hill ◽  
Lei Zheng ◽  
Jin He ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Clinical Outcomes ◽  
Older Patients ◽  
Stereotactic Body Radiation Therapy ◽  
Progression Free Survival ◽  
Radiation Toxicity ◽  
Free Survival ◽  
Stereotactic Body Radiation ◽  
Resection Status

Objective: To report on clinical outcomes and toxicity in older (age ≥ 70 years) patients with localized pancreatic cancer treated with upfront chemotherapy followed by stereotactic body radiation therapy (SBRT) with or without surgery. Methods: Endpoints included overall survival (OS), local progression-free survival (LPFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and toxicity. Results: A total of 57 older patients were included in the study. Median OS was 19.6 months, with six-month, one-year, and two-year OS rates of 83.4, 66.5, and 42.4%. On MVA, resection status (HR: 0.30, 95% CI 0.12–0.91, p = 0.031) was associated with OS. Patients with surgically resected tumors had improved median OS (29.1 vs. 7.0 months, p < 0.001). On MVA, resection status (HR: 0.40, 95% CI 0.17–0.93, p = 0.034) was also associated with PFS. Patients with surgically resected tumors had improved median PFS (12.9 vs. 1.6 months, p < 0.001). There were 3/57 cases (5.3%) of late grade 3 radiation toxicity and 2/38 cases (5.3%) of Clavien-Dindo grade 3b toxicity in those who underwent resection. Conclusion: Multimodality therapy involving SBRT is safe and feasible in older patients with localized pancreatic cancer. Surgical resection was associated with improved clinical outcomes. As such, older patients who complete chemotherapy should not be excluded from aggressive local therapy when possible.

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