scholarly journals Radiation pneumonitis in lung cancer treated with volumetric modulated arc therapy

2018 ◽  
Vol 10 (12) ◽  
pp. 6531-6539 ◽  
Author(s):  
Kan Wu ◽  
Xiao Xu ◽  
Xiadong Li ◽  
Jiahao Wang ◽  
Lucheng Zhu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Pneumonitis ◽  
Volumetric Modulated Arc Therapy ◽  
Arc Therapy

Radiation Pneumonitis After Volumetric Modulated Arc Therapy for Non-small Cell Lung Cancer

2021 ◽  
Vol 41 (11) ◽  
pp. 5793-5802
Author(s):  
MASAYUKI FUJIWARA ◽  
HIROSHI DOI ◽  
MASATAKA IGETA ◽  
HITOMI SUZUKI ◽  
KAZUHIRO KITAJIMA ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Radiation Pneumonitis ◽  
Volumetric Modulated Arc Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Arc Therapy

Potential benefits of volumetric modulated arc therapy to reduce the incidence of ≥ grade 2 radiation pneumonitis in radiotherapy for locally advanced non-small cell lung cancer patients

2021 ◽  
Author(s):  
Nobuki Imano ◽  
Tomoki Kimura ◽  
Daisuke Kawahara ◽  
Riku Nishioka ◽  
Wataru Fukumoto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Radiation Pneumonitis ◽  
Locally Advanced ◽  
Volumetric Modulated Arc Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Conformal Radiation Therapy ◽  
Arc Therapy

Abstract Background The use of volumetric modulated arc therapy is gradually widespread for locally advanced non-small cell lung cancer. The purpose of this study was to identify the factors that caused ≥ grade 2 radiation pneumonitis and evaluate the impact of using volumetric modulated arc therapy on the incidence of ≥ grade 2 radiation pneumonitis by comparing three-dimensional conformal radiation therapy. Methods We retrospectively evaluated 124 patients who underwent radical radiotherapy for locally advanced non-small cell lung cancer in our institution between 2008 and 2019. The following variables were analysed to detect the factors that affected ≥ grade 2 radiation pneumonitis; age, sex, the presence of interstitial lung disease, pulmonary emphysema, tumour location, stage, PTV/lung volume, lung V20Gy, total dose, concurrent chemoradiotherapy, adjuvant immune checkpoint inhibitor, radiotherapy method. Radiation pneumonitis was evaluated using the common terminology criteria for adverse events (version 5.0). Results A total of 84 patients underwent three-dimensional conformal radiation therapy (3D-CRT group) and 40 patients underwent volumetric modulated arc therapy (VMAT group). The cumulative incidence of ≥ grade 2 radiation pneumonitis at 12 months was significantly lower in the VMAT group than in the 3D-CRT group (25% vs. 49.1%). The use of volumetric modulated arc therapy was a significant factor for ≥ grade 2 radiation pneumonitis (HR:0.32, 95% CI: 0.15–0.65, P = 0.0017) in addition to lung V20Gy (≥ 24%, HR:5.72 (95% CI: 2.87–11.4), P < 0.0001) and total dose (≥ 70 Gy, HR:2.64 (95% CI: 1.39–5.03), P = 0.0031) even after adjustment by multivariate analysis. Conclusions We identified factors associated with ≥ grade 2 radiation pneumonitis in radiotherapy for patients with locally advanced non-small cell lung cancer. Volumetric modulated arc therapy has potential benefits to reduce the risk of ≥ grade 2 radiation pneumonitis.

Intensity-modulated radiation therapy versus volumetric-modulated arc therapy in non-small cell lung cancer: assessing the risk of radiation pneumonitis

2017 ◽  
Vol 17 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Sara Rosas ◽  
Bárbara Barbosa ◽  
José G. Couto
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Radiation Pneumonitis ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Intensity Modulated ◽  
Arc Therapy ◽  
Healthy Lung

AbstractPurposeThis study aimed to compare intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) regarding plan quality and healthy lung sparing, in stage III non-small cell lung cancer (NSCLC) patients.Materials and methodsThe plans of 60 patients were allocated either to the IMRT (n=30) or the VMAT (n=30) group. The dose prescribed to the planning target volume (PTV) was evaluated at the 95% level and the mean lung dose (MLD) and the healthy lung receiving 5, 10 and 20 Gy (V5, V10 and V20, respectively) were analysed. The normal tissue complication probability (NTCP) for radiation pneumonitis was calculated with the Lyman–Kutcher–Burman model.ResultsBoth techniques achieved comparable results for target coverage (V95%=97·87 versus 97·18%, p>0·05) and homogeneity. The MLD (15·57 versus 16·98 Gy, p>0·05), V5 (60·35 versus 67·25%, p>0·05) and V10 (45·22 versus 53·14%, p=0·011) were lower for IMRT, whereas VMAT reduced V20 (26·44 versus 25·90%, p>0·05). The NTCP for radiation pneumonitis was higher for VMAT, but no statistical significance was observed (11·07 versus 12·75, p>0·05).ConclusionBoth techniques seemed suitable for NSCLC treatment, but IMRT presented better results regarding lung sparing thus being beneficial in reducing the risk of radiation-induced pneumonitis.

scholarly journals Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans

2017 ◽  
Vol 16 (3) ◽  
pp. 366-372 ◽  
Author(s):  
Andrzej P. Wojcieszynski ◽  
Patrick M. Hill ◽  
Stephen A. Rosenberg ◽  
Craig R. Hullett ◽  
Zacariah E. Labby ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lung Cancer ◽  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Tumor Volume ◽  
Stereotactic Body Radiation Therapy ◽  
Volumetric Modulated Arc Therapy ◽  
Resonance Imaging ◽  
Stereotactic Body Radiation ◽  
Arc Therapy

Purpose: Magnetic resonance imaging–guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging–guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging–guided radiation therapy plans and internal target volume–based plans utilizing volumetric-modulated arc therapy. Materials and Methods: Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging–guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. Results: Planning tumor volumes trended larger for volumetric-modulated arc therapy–based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging–guided plans ( P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% ( P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL ( P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 ( P < .001). Heterogeneity index was comparable between plans, 1.25 versus 1.25 ( P = .98). Conclusion: Magnetic resonance imaging–guided tri-cobalt-60 radiation therapy is capable of delivering lung high-quality stereotactic body radiation therapy plans that are clinically acceptable as compared to volumetric-modulated arc therapy–based plans. Real-time magnetic resonance imaging provides the unique capacity to directly observe tumor motion during treatment for purposes of motion management.

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