PMID- 22579380
OWN - NLM
STAT- MEDLINE
DCOM- 20120731
LR  - 20120514
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 83
IP  - 2
DP  - 2012 Jun 1
TI  - Clinical application of a novel hybrid intensity-modulated radiotherapy technique 
      for stage III lung cancer and dosimetric comparison with four other techniques.
PG  - e297-303
LID - 10.1016/j.ijrobp.2011.12.059 [doi]
AB  - PURPOSE: In large stage III lung tumors, planning delivery of doses exceeding 60 
      Gy can be challenging and time consuming. Intensity modulated radiation therapy 
      (IMRT) can improve target coverage but may increase volumes receiving low-dose 
      irradiation. We clinically implemented a novel hybrid IMRT (h-IMRT) technique 
      that allowed plans to be produced quickly, and compared these plans with 4 other 
      techniques. METHODS AND MATERIALS: h-IMRT was used to treat 14 consecutive 
      patients with planning target volumes (PTVs) exceeding 500 cm(3) (average, 779 
      cm(3)) with concurrent chemo-radiation therapy to 66 Gy. h-IMRT plans consisted 
      of 2 components: an anterior-posterior/posterior-anterior/posterior-anterior 
      (AP-PA-PA) oblique, open-field technique delivering an average dose of 58 Gy, 
      plus a 3-field IMRT component optimized to achieve a final homogeneous dose of 66 
      Gy. Total lung V(20) and contralateral lung V(5) were kept as low as possible but 
      preferably less than 35% and less than 50%, respectively. All plans were 
      retrospectively replanned using a 5- to 9-field 3-dimensional conformal 
      technique, full RapidArc, 6-field full IMRT, and a hybrid RapidArc (h-RapidArc) 
      technique similar to the h-IMRT. RESULTS: The h-IMRT, h-RapidArc, and full 
      RapidArc plans could be generated in less than 2 h, with the first 2 plans 
      achieving the lowest V(5) (36%) and V(20) (30%) values together with the smallest 
      hot spots. Both the 3-dimensional conformal and full IMRT plans occasionally led 
      to unacceptable hot spots outside the PTV. Full RapidArc plans were fast and 
      achieved comparable V(20) values but led to slightly higher V(5) values. 
      CONCLUSIONS: Both h-IMRT and h-RapidArc permitted delivery of 66 Gy to large 
      stage III lung tumors, and both were superior to either full IMRT or RapidArc 
      plans for reducing lung doses. The clinical significance of small increases in 
      V(5) during chemo-radiation therapy delivery are unknown, but the present study 
      suggests that h-IMRT and h-RapidArc are preferable for treatment of large tumors.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Verbakel, Wilko F A R
AU  - Verbakel WF
AD  - VU University Medical Center, Amsterdam, The Netherlands. w.verbakel@vumc.nl
FAU - van Reij, Ellen
AU  - van Reij E
FAU - Ladenius-Lischer, Ilonka
AU  - Ladenius-Lischer I
FAU - Cuijpers, Johan P
AU  - Cuijpers JP
FAU - Slotman, Ben J
AU  - Slotman BJ
FAU - Senan, Suresh
AU  - Senan S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Carcinoma, Non-Small-Cell Lung/drug therapy/pathology/*radiotherapy
MH  - Chemoradiotherapy
MH  - Esophagitis/etiology
MH  - Humans
MH  - Lung Neoplasms/drug therapy/pathology/*radiotherapy
MH  - Neoplasm Staging
MH  - Radiation Pneumonitis/etiology
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Retrospective Studies
MH  - Tumor Burden
EDAT- 2012/05/15 06:00
MHDA- 2012/08/01 06:00
CRDT- 2012/05/15 06:00
PHST- 2011/06/16 00:00 [received]
PHST- 2011/12/13 00:00 [revised]
PHST- 2011/12/14 00:00 [accepted]
PHST- 2012/05/15 06:00 [entrez]
PHST- 2012/05/15 06:00 [pubmed]
PHST- 2012/08/01 06:00 [medline]
AID - S0360-3016(11)03763-1 [pii]
AID - 10.1016/j.ijrobp.2011.12.059 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 Jun 1;83(2):e297-303. doi: 
      10.1016/j.ijrobp.2011.12.059.