[The impact of 4DCT-ventilation imaging-guided proton therapy on stereotactic body radiotherapy for lung cancer]
| Autor: | Kenji Nemoto, Kazuhiro Arai, Takayuki Kanai, Keiichi Jingu, Kengo Ito, Takahiro Kato, Yujiro Nakajima, Ken Takeda, Takeo Iwai, Yoshiro Ieko, Yuya Miyasaka, Noriyuki Kadoya |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Lung Neoplasms Pulmonary toxicity medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Radiosurgery 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Region of interest Proton Therapy Medicine Humans Radiology Nuclear Medicine and imaging Four-Dimensional Computed Tomography Lung cancer Proton therapy Lung Aged Retrospective Studies Radiation business.industry Radiotherapy Planning Computer-Assisted Respiration General Medicine medicine.disease Radiation therapy medicine.anatomical_structure 030220 oncology & carcinogenesis Breathing Female business Nuclear medicine Pulmonary Ventilation Stereotactic body radiotherapy Radiotherapy Image-Guided |
| Zdroj: | Igaku butsuri : Nihon Igaku Butsuri Gakkai kikanshi = Japanese journal of medical physics : an official journal of Japan Society of Medical Physics. 41(3) |
| ISSN: | 1345-5354 |
| Popis: | Functional lung avoidance during radiotherapy can help reduce pulmonary toxicity. This study assessed the potential impact of four-dimensional computed tomography (4DCT)-ventilation imaging-guided proton radiotherapy (PT) on stereotactic body radiotherapy (SBRT) by comparing it with three-dimensional conformal radiotherapy (3D-CRT) and volumetric modulated arc therapy (VMAT), which employ photon beams. Thirteen lung cancer patients who received SBRT with 3D-CRT were included in the study. 4DCT ventilation was calculated using the patients’ 4DCT data, deformable image registration, and a density-change-based algorithm. Three functional treatment plans sparing the functional lung regions were developed for each patient using 3D-CRT, VMAT, and PT. The prescribed doses and dose constraints were based on the Radiation Therapy Oncology Group 0618 protocol. We evaluated the region of interest (ROI) and functional map-based dose-function metrics for 4DCT ventilation and the irradiated dose. Using 3D-CRT, VMAT, and PT, the percentages of the functional lung regions that received ≥ 5 Gy (fV5) were 26.0%, 21.9%, and 10.7%, respectively; the fV10 were 14.4%, 11.4%, and 9.0%, respectively; and fV20 were 6.5%, 6.4%, and 6.6%, respectively, and the functional mean lung doses (fMLD) were 5.6 Gy, 5.2 Gy, and 3.8 Gy, respectively. These results indicated that PT resulted in a significant reduction in fMLD, fV5, and fV10, but not fV20. The use of PT reduced the radiation to highly functional lung regions compared with those for 3D-CRT and VMAT while meeting all dose constraints. |
| Databáze: | OpenAIRE |
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