PMID- 16618580
OWN - NLM
STAT- MEDLINE
DCOM- 20060522
LR  - 20211020
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 65
IP  - 1
DP  - 2006 May 1
TI  - Multiple fields may offer better esophagus sparing without increased probability 
      of lung toxicity in optimized IMRT of lung tumors.
PG  - 255-65
AB  - PURPOSE: To evaluate whether increasing numbers of intensity-modulated radiation 
      therapy (IMRT) fields enhance lung-tumor dose without additional predicted 
      toxicity for difficult planning geometries. METHODS AND MATERIALS: Data from 8 
      previous three dimensional conformal radiation therapy (3D-CRT) patients with 
      tumors located in various regions of each lung, but with planning target volumes 
      (PTVs) overlapping part of the esophagus, were used as input. Four 
      optimized-beamlet IMRT plans (1 plan that used the 3D-CRT beam arrangement and 3 
      plans with 3, 5, or 7 axial, but predominantly one-sided, fields) were compared. 
      For IMRT, the equivalent uniform dose (EUD) in the whole PTV was optimized 
      simultaneously with that in a reduced PTV exclusive of the esophagus. 
      Normal-tissue complication probability-based costlets were used for the 
      esophagus, heart, and lung. RESULTS: Overall, IMRT plans (optimized by use of EUD 
      to judiciously allow relaxed PTV dose homogeneity) result in better minimum PTV 
      isodose surface coverage and better average EUD values than does conformal 
      planning; dose generally increases with the number of fields. Even 7-field plans 
      do not significantly alter normal-lung mean-dose values or lung volumes that 
      receive more than 13, 20, or 30 Gy. CONCLUSION: Optimized many-field IMRT plans 
      can lead to escalated lung-tumor dose in the special case of esophagus 
      overlapping PTV, without unacceptable alteration in the dose distribution to 
      normal lung.
FAU - Chapet, Olivier
AU  - Chapet O
AD  - Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 
      48109-0010, USA.
FAU - Fraass, Benedick A
AU  - Fraass BA
FAU - Ten Haken, Randall K
AU  - Ten Haken RK
LA  - eng
GR  - P01 CA059827/CA/NCI NIH HHS/United States
GR  - P01CA59872/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Esophagus/diagnostic imaging/*radiation effects
MH  - Heart/radiation effects
MH  - Humans
MH  - Lung/radiation effects
MH  - Lung Neoplasms/diagnostic imaging/*radiotherapy
MH  - Radiation Injuries/*prevention & control
MH  - Radiography
MH  - Radiotherapy Dosage
MH  - Radiotherapy, Conformal/methods
MH  - Radiotherapy, Intensity-Modulated/*methods/standards
MH  - Spinal Cord/radiation effects
EDAT- 2006/04/19 09:00
MHDA- 2006/05/23 09:00
CRDT- 2006/04/19 09:00
PHST- 2005/09/20 00:00 [received]
PHST- 2005/12/17 00:00 [revised]
PHST- 2005/12/19 00:00 [accepted]
PHST- 2006/04/19 09:00 [pubmed]
PHST- 2006/05/23 09:00 [medline]
PHST- 2006/04/19 09:00 [entrez]
AID - S0360-3016(05)03099-3 [pii]
AID - 10.1016/j.ijrobp.2005.12.028 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):255-65. doi: 
      10.1016/j.ijrobp.2005.12.028.