PMID- 22100654
OWN - NLM
STAT- MEDLINE
DCOM- 20120619
LR  - 20161125
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 102
IP  - 2
DP  - 2012 Feb
TI  - Comparison of anisotropic aperture based intensity modulated radiotherapy with 
      3D-conformal radiotherapy for the treatment of large lung tumors.
PG  - 268-73
LID - 10.1016/j.radonc.2011.10.006 [doi]
AB  - PURPOSE/OBJECTIVE(S): IMRT allows dose escalation for large lung tumors, but 
      respiratory motion may compromise delivery. A treatment plan that modulates 
      fluence predominantly in the transversal direction and leaves the fluence 
      identical in the direction of the breathing motion may reduce this problem. 
      MATERIALS/METHODS: Planning-CT-datasets of 20 patients with Stage I-IV non small 
      cell lung cancer (NSCLC) formed the basis of this study. A total of two IMRT 
      plans and one 3D plan were created for each patient. Prescription dose was 60 Gy 
      to the CTV and 70 Gy to the GTV. For the 3D plans an energy of 18 MV photons was 
      used. IMRT plans were calculated for 6 MV photons with 13 coplanar and with 17 
      noncoplanar beams. Robustness of the used method of anisotropic modulation toward 
      breathing motion was tested in a 13-field IMRT plan. RESULTS: As a consequence of 
      identical prescription doses, mean target doses were similar for 3D and IMRT. 
      Differences between 3D and 13- and 17-field IMRT were significant for CTV Dmin 
      (43 Gy vs. 49.1 Gy vs. 48.6 Gy; p<0.001) and CTV D(95) (53.2 Gy vs. 55.0 Gy vs. 
      55.4 Gy; p=0.001). The D(mean) of the contralateral lung was significantly lower 
      in the 17-field plans (17-field IMRT vs. 13- vs. 3D: 12.5 Gy vs. 14.8 Gy vs. 15.8 
      Gy: p<0.05). The spinal cord dose limit of 50 Gy was always respected in IMRT 
      plans and only in 17 of 20 3D-plans. Heart D(max) was only marginally reduced 
      with IMRT (3D vs. 13- vs. 17-field IMRT: 38.2 Gy vs. 36.8 Gy vs. 37.8 Gy). 
      Simulated breathing motion caused only minor changes in the IMRT dose 
      distribution (~0.5-1 Gy). CONCLUSIONS: Anisotropic modulation of IMRT improves 
      dose delivery over 3D-RT and renders IMRT plans robust toward breathing induced 
      organ motion, effectively preventing interplay effects.
CI  - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved.
FAU - Simeonova, Anna
AU  - Simeonova A
AD  - Department of Radiation Oncology, University of Heidelberg, Mannheim, Germany. 
      anna.simeonova@gmail.com
FAU - Abo-Madyan, Yasser
AU  - Abo-Madyan Y
FAU - El-Haddad, Mostafa
AU  - El-Haddad M
FAU - Welzel, Grit
AU  - Welzel G
FAU - Polednik, Martin
AU  - Polednik M
FAU - Boggula, Ramesh
AU  - Boggula R
FAU - Wenz, Frederik
AU  - Wenz F
FAU - Lohr, Frank
AU  - Lohr F
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20111117
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anisotropy
MH  - Carcinoma, Non-Small-Cell Lung/diagnostic imaging/pathology/*radiotherapy
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/diagnostic imaging/pathology/*radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Conformal/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Respiration
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
EDAT- 2011/11/22 06:00
MHDA- 2012/06/20 06:00
CRDT- 2011/11/22 06:00
PHST- 2010/11/17 00:00 [received]
PHST- 2011/09/19 00:00 [revised]
PHST- 2011/10/07 00:00 [accepted]
PHST- 2011/11/22 06:00 [entrez]
PHST- 2011/11/22 06:00 [pubmed]
PHST- 2012/06/20 06:00 [medline]
AID - S0167-8140(11)00608-6 [pii]
AID - 10.1016/j.radonc.2011.10.006 [doi]
PST - ppublish
SO  - Radiother Oncol. 2012 Feb;102(2):268-73. doi: 10.1016/j.radonc.2011.10.006. Epub 
      2011 Nov 17.