PMID- 16722527
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20091214
LR  - 20181113
IS  - 1748-717X (Print)
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 1
DP  - 2006 Mar 31
TI  - A dosimetric analysis of respiration-gated radiotherapy in patients with stage 
      III lung cancer.
PG  - 8
AB  - BACKGROUND: Respiration-gated radiotherapy can permit the irradiation of smaller 
      target volumes. 4DCT scans performed for routine treatment were retrospectively 
      analyzed to establish the benefits of gating in stage III non-small cell lung 
      cancer (NSCLC). MATERIALS AND METHODS: Gross tumor volumes (GTVs) were contoured 
      in all 10 respiratory phases of a 4DCT scan in 15 patients with stage III NSCLC. 
      Treatment planning was performed using different planning target volumes (PTVs), 
      namely: (i) PTVroutine, derived from a single GTV plus 'conventional' margins; 
      (ii) PTVall phases incorporating all 3D mobility captured by the 4DCT; (iii) 
      PTVgating, incorporating residual 3D mobility in 3-4 phases at end-expiration. 
      Mixed effect models were constructed in order to estimate the reductions in risk 
      of lung toxicity for the different PTVs. RESULTS: Individual GTVs ranged from 
      41.5 - 235.0 cm3. With patient-specific mobility data (PTVall phases), smaller 
      PTVs were derived than when 'standard' conventional margins were used (p < 
      0.001). The average residual 3D tumor mobility within the gating window was 4.0 
      +/- 3.5 mm, which was 5.5 mm less than non-gated tumor mobility (p < 0.001). The 
      reductions in mean lung dose were 9.7% and 4.9%, respectively, for PTVall phases 
      versus PTVroutine, and PTVgating versus PTVall phases. The corresponding 
      reductions in V20 were 9.8% and 7.0%, respectively. Dosimetric gains were smaller 
      for primary tumors of the upper lobe versus other locations (p = 0.02). 
      Respiratory gating also reduced the risks of radiation-induced esophagitis. 
      CONCLUSION: Respiration-gated radiotherapy can reduce the risk of pulmonary 
      toxicity but the benefits are particularly evident for tumors of the middle and 
      lower lobes.
FAU - Underberg, Rene W M
AU  - Underberg RW
AD  - Department of Radiation Oncology, VU University medical center, Amsterdam, The 
      Netherlands. rwm.underberg@vumc.nl
FAU - van Sornsen de Koste, John R
AU  - van Sornsen de Koste JR
FAU - Lagerwaard, Frank J
AU  - Lagerwaard FJ
FAU - Vincent, Andrew
AU  - Vincent A
FAU - Slotman, Ben J
AU  - Slotman BJ
FAU - Senan, Suresh
AU  - Senan S
LA  - eng
PT  - Journal Article
DEP - 20060331
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
PMC - PMC1488861
EDAT- 2006/05/26 09:00
MHDA- 2006/05/26 09:01
PMCR- 2006/03/31
CRDT- 2006/05/26 09:00
PHST- 2006/01/16 00:00 [received]
PHST- 2006/03/31 00:00 [accepted]
PHST- 2006/05/26 09:00 [pubmed]
PHST- 2006/05/26 09:01 [medline]
PHST- 2006/05/26 09:00 [entrez]
PHST- 2006/03/31 00:00 [pmc-release]
AID - 1748-717X-1-8 [pii]
AID - 10.1186/1748-717X-1-8 [doi]
PST - epublish
SO  - Radiat Oncol. 2006 Mar 31;1:8. doi: 10.1186/1748-717X-1-8.