| Jian Hu,Ximing Xu,Guangjin Yuan,Wei Ge,Liming Xu,Aihua Zhang,Junjian Deng. Dosimetric consequences of tumor volume changes after kilovoltage cone-beam computed tomography for non-operative lung cancer during adaptive intensity-modulated radiotherapy or fractionated stereotactic radiotherapy. Oncol Transl Med, 2015, 1: 195-200. |
| Dosimetric consequences of tumor volume changes after kilovoltage cone-beam computed tomography for non-operative lung cancer during adaptive intensity-modulated radiotherapy or fractionated stereotactic radiotherapy |
| Received:January 08, 2015 Revised:October 08, 2015 |
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| KeyWord:lung cancer; kilovoltage cone-beam computed tomography (kV-CBCT); intensity-modulated radiotherapy (IMRT); stereotactic radiotherapy; tumor changes; adaptive planning |
| Author Name | Affiliation | E-mail | | Jian Hu | Cancer Center, Renmin Hospital of Wuhan University, Wuhan 430060, China | whuxxm@yaoo.com | | Ximing Xu | Cancer Center, Renmin Hospital of Wuhan University, Wuhan 430060, China | Doctorxu120@aliyun.com | | Guangjin Yuan | Department of Oncology, Qianjiang Nationality Hospital, Chongqing 409000, China | whuxxm@yaoo.com | | Wei Ge | Cancer Center, Renmin Hospital of Wuhan University, Wuhan 430060, China | whuxxm@yaoo.com | | Liming Xu | Cancer Center, Renmin Hospital of Wuhan University, Wuhan 430060, China | whuxxm@yaoo.com | | Aihua Zhang | Cancer Center, Renmin Hospital of Wuhan University, Wuhan 430060, China | whuxxm@yaoo.com | | Junjian Deng | Cancer Center, Renmin Hospital of Wuhan University, Wuhan 430060, China | whuxxm@yaoo.com |
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| Abstract: |
| Objective: The aim of this study was to investigate tumor volume changes with kilovoltage cone-beam computed tomography (kV-CBCT) and their dosimetric consequences for non-operative lung cancer during intensity-modulated radiotherapy (IMRT) or fractionated stereotactic radiotherapy.
Methods: Eighteen patients with non-operative lung cancer who received IMRT consisting of 1.8–2.2 Gy/fraction and five fractions per week or stereotactic radiotherapy with 5–8 Gy/fraction and three fractions a week were studied. kV-CBCT was performed once per week during IMRT and at every fraction during stereotactic radiotherapy. The gross tumor volume (GTV) was contoured on the kV-CBCT images, and adaptive treatment plans were created using merged kV-CBCT and primary planning computed tomography image sets. Tumor volume changes and dosimetric parameters, including the minimum dose to 95% (D95) or 1% (D1) of the planning target volume (PTV), mean lung dose (MLD), and volume of lung tissue that received more than 5 (V5), 10 (V10), 20 (V20), and 30 (V30) Gy were retrospectively analyzed.
Results: The average maximum change in GTV observed during IMRT or fractionated stereotactic radiotherapy was –25.85% (range, –13.09% – –56.76%). The D95 and D1 of PTV for the adaptive treatment plans in all patients were not significantly different from those for the initial or former adaptive treatment plans. In patients with tumor volume changes of >20% in the third or fourth week of treatment during IMRT, adaptive treatment plans offered clinically meaningful decreases in MLD and V5, V10, V20, and V30; however, in patients with tumor volume changes of < 20% in the third or fourth week of treatment as well as in patients with stereotactic radiotherapy, there were no significant or clinically meaningful decreases in the dosimetric parameters.
Conclusion: Adaptive treatment planning for decreasing tumor volume during IMRT may be beneficial for patients who experience tumor volume changes of >20% in the third or fourth week of treatment. |
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