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Selection of patient for gated treatment based on the information from 4DCT imaging in stereotactic body radiotherapy of non-small cell lung cancer

Published online by Cambridge University Press:  14 November 2018

N. V. N. Madhusudhana Sresty Open the ORCID record for N. V. N. Madhusudhana Sresty [Opens in a new window] ,
A. Krishnam Raju ,
S. D. Sharma ,
T. Anil Kumar ,
Shabbir Ahamed  and
Harjot Kaur Bajwa
N. V. N. Madhusudhana Sresty*
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
A. Krishnam Raju
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
S. D. Sharma
Affiliation:
Radiological Physics & Advisory Division, Bhabha Atomic Research Center, Mumbai, India, Research conducted atBasavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
T. Anil Kumar
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
Shabbir Ahamed
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
Harjot Kaur Bajwa
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
*
Author for correspondence: Dr N. V. N. Madhusudhana Sresty, Head—Medical Physics, Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Road No: 14, Banjara Hills, Hyderabad 500034, India. Tel:+91- 9985151221, Fax: 040-23542120. E-mail: [email protected]
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Abstract

Purpose

Stereotactic body radiotherapy (SBRT) is widely used for the treatment of stage-I non-small cell lung cancer (NSCLC). Patient-specific motion correlated with 4DCT could be essential for hypofractionated SBRT. All patients undergoing SBRT do not require motion management during the dose delivery. The objective of this study was to evaluate which patient may benefit from Gated SBRT.

Materials and methods

Treatment planning of 20 patients of stage-I NSCLC was analysed. Conventional and 4DCT scans were taken. Internal target volume as well as planning target volume (ITV and PTV) were determined in the CT data sets. PTVall phases created using 4DCT data sets and PTV15mm created using conventional CT data were compared. Also, ITVall phases were compared with ITV created from maximum intensity projections (ITVMIP). Suitability of patients for motion management-based treatment delivery was also evaluated.

Results

The average ITVMIP to ITVall phases ratio is 1·06 indicating good agreement between them. Based on the ratio of intensity projections, 9 out of 17 patients were found suitable for our existing gated treatment.

Conclusion

4D CT is the main requirement in SBRT to identify the patients who can benefit from motion management during the dose delivery.

Keywords

4DCTgatinglung cancermotion managementSBRT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 2 , June 2019 , pp. 175 - 179
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Sresty NVNM, Raju AK, Sharma SD, Kumar TA, Ahamed S, Bajwa HK. (2019) Selection of patient for gated treatment based on the information from 4DCT imaging in stereotactic body radiotherapy of non-small cell lung cancer. Journal of Radiotherapy in Practice18: 175–179. doi: 10.1017/S1460396918000614

References

1. Keall, P, Mageras, G, Balter, J.M., et al. The management of respiratory motion in radiation oncology report of AAPM Task Group 76. Med Phys 2006; 33: 3874–3900.Google Scholar
2. Ishihara, Y, Nakamura, M, Miyabe, Y. et al. Development of a four-dimensional Monte Carlo dose calculation system for real-time tumor-tracking irradiation with a gimbaled X-ray head. Phys Med 2017; 35: 59–65. doi: 10.1016/j.ejmp.2017.02.004.Google Scholar
3. Seppenwoolde, Y, Shirato, H, Kitamura, K et al. Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy. Int J Radiat Oncol Biol Phys 2002; 53: 822–834.Google Scholar
4. Benedict, S, Yenice, K, Followill, D et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 2010; 37: 4078–4101.Google Scholar
5. Simone, C, Dorsey, J. Additional data in the debate on stage I non-small cell lung cancer: surgery versus stereotactic ablative radiotherapy. Ann Transl Med 2015; 3: 172.Google Scholar
6 Zheng, X, Schipper, M, Kidwell, K et al. Survival outcome after stereotactic body radiation therapy and surgery for stage I non-small cell lung cancer: a meta-analysis. Int J Radiat Oncol Biol Phys 2014; 90: 603–611.Google Scholar
7. van der Geld, Y, Lagerwaard, G, van Sörnsen de Koste, J, Cuijpers, J, Slotman, B, enan, S. Reproducibility of target volumes generated using uncoached 4-dimensional CT scans for peripheral lung cancer. Radiat Oncol 2006; 1: 43.Google Scholar
8. Chen, G, Kung, J, Beaudette, K. Artifacts in computed tomography scanning of moving objects. Sem Radiat Oncol 2004; 14: 19–26.Google Scholar
9. Bettinardi, V, Picchio, M, Muzio, N, Gianolli, L, Gilardi, M, Messa, C. Detection and compensation of organ/lesion motion using 4D-PET/CT respiratory gated acquisition techniques. Radiother Oncol 2010; 96: 311–316.Google Scholar
10. Shimizu, S, Shirato, H, Kagei, K et al. Impact of respiratory movement on the computed tomographic images of small lung tumors in three-dimensional (3D) radiotherapy. Int J Radiat Oncol Biol Phys 2000; 46: 1127–1133.Google Scholar
11. International Commission on Radiation Units and Measurements. ICRU Report 62: Prescribing, Recording, and Reporting Photon Beam Therapy (Supplement to ICRU Report 50). Bethesda, MD: ICRU, 1999.Google Scholar
12. Giraud, P, Morvan, E, Claude, L et al. Respiratory gating techniques for optimization of lung cancer radiotherapy. J Thorac Oncol 2011; 6: 2058–2068.Google Scholar
13. Goitein, M. Organ and tumor motion: an overview. Semin Radiat Oncol 2004; 14: 2–9.Google Scholar
14. Giraud, P, De Rycke, Y, Dubray, B et al. Conformal radiotherapy (CRT) planning for lung cancer: analysis of intrathoracic organ motion during extreme phases of breathing. Int J Radiat Oncol Biol Phys 2001; 51: 1081–1092.Google Scholar
15. Van Sornsen de Koste, J, Lagerwaard, F, Nijssen Visser, MRJ et al. Tumor location cannot predict the mobility of lung tumors: a 3D analysis of data generated from multiple CT scans. Int J Radiat Oncol Biol Phys 2003; 56: 348–354.Google Scholar
16. Lagerwaard, F, van Sornsen de Koste, J, Nijssen-Visser, MRJ et al. Multiple ‘slow’ CT scans for incorporating lung tumor mobility in radiotherapy planning. Int J Radiat Oncol Biol Phys 2001; 51: 932–937.Google Scholar
17. van Sörnsen de Koste, J, Lagerwaard, F, de Boer, HCR et al. Are multiple CT scans required for planning curative radiotherapy in lung tumors of the lower lobe? Int J Radiat Oncol Phys 2003; 55: 1394–1399.Google Scholar
18. Underberg, RWM, Lagerwaard, F, Cuijpers, J.P et al. 4-Dimensional CT scans for treatment planning in stereotactic radiotherapy for stage I lung cancer. Int J Radiat Oncol Biol Phys 2004; 60: 1283–1290.Google Scholar
19. Underberg, RWM, Lagerwaard, F, Slotman, B et al. Benefit of respiration-gated stereotactic radiotherapy for stage I lung cancer – an analysis of 4DCT datasets. Int J Radiat Oncol Biol Phys 2005; 62: 554–560.Google Scholar
20. Schwarz, M, Cattaneo, G, Marrazzo, L. Geometrical and dosimetrical uncertainties in hypofractionated radiotherapy of the lung: a review. Phys Med 2017; 36: 126–139. doi: 10.1016/j.ejmp.2017.02.011.Google Scholar
21. Caillet, V, Booth, J, Keall, P. IGRT and motion management during lung SBRT delivery. Phys Med 2017; 44: 113–122. doi: 10.1016/j.ejmp.2017.06.006.Google Scholar
22. Uchida, Y, Tachibana, H, Kamei, Y, Kashihara, K. Effectiveness of a simple and real-time baseline shift monitoring system during stereotactic body radiation therapy of lung tumors. Phys Med 2017; 43: 100–106. doi: 10.1016/j.ejmp.2017.11.001.Google Scholar
23. Underberg, RWM, Lagerwaard, F, Slotman, B, Cuijpers, J, Senan, S. Use of maximum intensity projections (MIP) for target volume generation in 4DCT scans for lung cancer. Int J Radiat Oncol Biol Phys 2005; 63: 253–260.10.1016/j.ijrobp.2005.05.045Google Scholar
24. Saito, T, Matsuyama, T, Toya, R et al. Respiratory gating during stereotactic body radiotherapy for lung cancer reduces tumor position variability. PLoS One 2014; 9 (11): e112824. doi: 10.1371/journal.pone.0112824.Google Scholar