Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation
| Autor: | Tsuyoshi Fukuzawa, Etsuo Kunieda, Tadashi Kitahara, Ryuta Nagao, Tetsuya Komatsu, Takeshi Akiba |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Dose-volume histogram Lung Neoplasms Health Toxicology and Mutagenesis medicine.medical_treatment 030204 cardiovascular system & hematology Radiosurgery Metastasis 03 medical and health sciences 0302 clinical medicine primary lung cancer Humans Medicine Radiology Nuclear Medicine and imaging Esophagus Lung cancer Lymph node Aged Aged 80 and over Radiation business.industry elective nodal irradiation Radiotherapy Dosage Middle Aged medicine.disease Radiation therapy Treatment Outcome Lymphatic system medicine.anatomical_structure Oncology stereotactic body radiotherapy Organ Specificity Lymphatic Metastasis 030220 oncology & carcinogenesis Feasibility Studies Female dose–volume histogram business Nuclear medicine |
| Zdroj: | Journal of Radiation Research |
| ISSN: | 1349-9157 0449-3060 |
| Popis: | More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V20 of the lung, D(1cm3) of the spinal cord, D(1cm3) and D(10cm3) of the esophagus and D(10cm3) of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible. |
| Databáze: | OpenAIRE |
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