417 poster FUNCTIONAL AVOIDANCE THROUGH MEAN LUNG DOSE AND BEAM ANGLES OPTIMIZATION FOR LUNG CANCER IMRT

2011 ◽  
Vol 99 ◽  
pp. S166
Author(s):  
J. St-Hilaire ◽  
A. Dagnault ◽  
C. Lavoie ◽  
F. Beaulieu ◽  
F. Morin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Dose ◽  
Mean Lung Dose

scholarly journals The Dosimetric and Temporal Effects of Respiratory-Gated, High-Dose-Rate Radiation Therapy in Patients With Lung Cancer

2018 ◽  
Vol 18 ◽  
pp. 153303381881607 ◽  
Author(s):  
Ouided Rouabhi ◽  
Brandie Gross ◽  
John Bayouth ◽  
Junyi Xia
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Dose Rate ◽  
Treatment Time ◽  
High Dose Rate ◽  
High Dose ◽  
Lung Dose ◽  
Treatment Delivery ◽  
Treatment Plans ◽  
Mean Lung Dose

Purpose: To evaluate the dosimetric and temporal effects of high-dose-rate respiratory-gated radiation therapy in patients with lung cancer. Methods: Treatment plans from 5 patients with lung cancer (3 nongated and 2 gated at 80EX-80IN) were retrospectively evaluated. Prescription dose for these patients varied from 8 to 18 Gy/fraction with 3 to 5 treatment fractions. Using the same treatment planning criteria, 4 new treatment plans, corresponding to 4 gating windows (20EX-20IN, 40EX-40IN, 60EX-60IN, and 80EX-80IN), were generated for each patient. Mean tumor dose, mean lung dose, and lung V20 were used to assess the dosimetric effects. A MATLAB algorithm was developed to compute treatment time. Results: Mean lung dose and lung V20 were on average reduced between −16.1% to −6.0% and −20.0% to −7.2%, respectively, for gated plans when compared to the corresponding nongated plans, and between −5.8% to −4.2% and −7.0% to −5.4%, respectively, for plans with smaller gating windows when compared to the corresponding plans gated at 80EX-80IN. Treatment delivery times of gated plans using high-dose rate were reduced on average between −19.7% (−0.10 min/100 MU) and −27.2% (−0.13 min/100 MU) for original nongated plans and −15.6% (−0.15 min/100 MU) and −20.3% (−0.19 min/100 MU) for original 80EX-80IN-gated plans. Conclusion: Respiratory-gated radiation therapy in patients with lung cancer can reduce lung dose while maintaining tumor dose. Because treatment delivery during gated therapy is discontinuous, total treatment time may be prolonged. However, this increase in treatment time can be offset by increasing the dose delivery rate. Estimation of treatment time may be helpful in selecting patients for respiratory gating and choosing appropriate gating windows.

scholarly journals Chemoradiotherapy by intensity-modulated radiation therapy with simultaneous integrated boost in locally advanced or oligometastatic non-small-cell lung cancer—a two center experience

2021 ◽  
Vol 197 (5) ◽  
pp. 405-415
Author(s):  
Frederick Mantel ◽  
Elena Müller ◽  
Philip Kleine ◽  
Marcus Zimmermann ◽  
Florian Exner ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Locally Advanced ◽  
Intensity Modulated Radiation Therapy ◽  
Small Cell ◽  
Lung Dose ◽  
Small Cell Lung ◽  
Integrated Boost ◽  
Mean Lung Dose

Abstract Purpose Integrating moderate hypofractionation to the macroscopic tumor with elective nodal irradiation while sparing the organs at risk (OAR) in chemoradiotherapy of locally advanced non-small-cell lung cancer. Methods From 2010–2018, treatment, patient and tumor characteristics of 138 patients from two radiation therapy centers were assessed. Chemoradiotherapy by intensity-modulated radiation therapy (IMRT) with a simultaneous integrated boost (SIB) to the primary tumor and macroscopic lymph node metastases was used. Results A total of 124 (90%) patients received concurrent chemotherapy. 106 (76%) patients had UICC (Union for International Cancer Control) stage ≥IIIB and 21 (15%) patients had an oligometastatic disease (UICC stage IV). Median SIB and elective total dose was 61.6 and 50.4 Gy in 28 fractions, respectively. Furthermore, 64 patients (46%) had an additional sequential boost to the primary tumor after the SIB-IMRT main series: median 6.6 Gy in median 3 fractions. The median cumulative mean lung dose was 15.6 Gy (range 6.2–29.5 Gy). Median follow-up and radiological follow-up for all patients was 18.0 months (range 0.6–86.9) and 16.0 months (range 0.2–86.9), respectively. Actuarial local control rates at 1, 2 and 3 years were 80.4, 68.4 and 57.8%. Median overall survival and progression-free survival was 30.0 months (95% confidence interval [CI] 23.5–36.4) and 12.1 months (95% CI 8.2–16.0), respectively. Treatment-related toxicity was moderate. Radiation-induced pneumonitis grade 2 and grade 3 occurred in 13 (9.8%) and 3 (2.3%) patients. Conclusions Chemoradiotherapy using SIB-IMRT showed promising local tumor control rates and acceptable toxicity in patients with locally advanced and in part oligometastatic lung cancer. The SIB concept, resulting in a relatively low mean lung dose, was associated with low numbers of clinically relevant pneumonitis. The overall survival appears promising in the presence of a majority of patients with UICC stage ≥IIIB disease.

scholarly journals Mid-position treatment strategy for locally advanced lung cancer: a dosimetric study

2020 ◽  
Vol 93 (1110) ◽  
pp. 20190692
Author(s):  
M. Ayadi ◽  
T. Baudier ◽  
G. Bouilhol ◽  
P. Dupuis ◽  
P. Boissard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Organs At Risk ◽  
Locally Advanced ◽  
Maximum Intensity Projection ◽  
Target Volume ◽  
Advanced Lung Cancer ◽  
Lung Dose ◽  
Internal Target Volume ◽  
Randomized Clinical Study ◽  
Mean Lung Dose

Objective: The internal target volume (ITV) strategy generates larger planning target volumes (PTVs) in locally advanced non-small cell lung cancer (LA-NSCLC) than the Mid-position (Mid-p) strategy. We investigated the benefit of the Mid-p strategy regarding PTV reduction and dose to the organs at risk (OARs). Methods: 44 patients with LA-NSCLC were included in a randomized clinical study to compare ITV and Mid-p strategies. GTV were delineated by a physician on maximum intensity projection images and on Mid-p images from four-dimensional CTs. CTVs were obtained by adding 6 mm uniform margin for microscopic extension. CTV to PTV margins were calculated using the van Herk's recipe for setup and delineation errors. For the Mid-p strategy, the mean target motion amplitude was added as a random error. For both strategies, three-dimensional conformal plans delivering 60–66 Gy to PTV were performed. PTVs, dose–volume parameters for OARs (lung, esophagus, heart, spinal cord) were reported and compared. Results: With the Mid-p strategy, the median of volume reduction was 23.5 cm3 (p = 0.012) and 8.8 cm3 (p = 0.0083) for PTVT and PTVN respectively; the median mean lung dose reduction was 0.51 Gy (p = 0.0057). For 37.1% of the patients, delineation errors led to smaller PTV with the ITV strategy than with the Mid-p strategy. Conclusion: PTV and mean lung dose were significantly reduced using the Mid-p strategy. Delineation uncertainty can unfavorably impact the advantage. Advances in knowledge: To the best of our knowledge, this is the first dosimetric comparison study between ITV and Mid-p strategies for LA-NSCLC.

scholarly journals PO-0999 Functional Avoidance planning allows for lung dose reduction in radiotherapy of lung cancer

2019 ◽  
Vol 133 ◽  
pp. S550-S551
Author(s):  
K. Farr ◽  
K. West ◽  
R. Yeghiaian-Alvandi ◽  
D. Farlow ◽  
R. Stensmyr ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Dose Reduction ◽  
Lung Dose

Method of predicting the mean lung dose based on a patient׳s anatomy and dose-volume histograms

2017 ◽  
Vol 42 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Anna Zawadzka ◽  
Marta Nesteruk ◽  
Beata Brzozowska ◽  
Paweł F. Kukołowicz
Keyword(s):  
Lung Dose ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
The Mean ◽  
Mean Lung Dose
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