Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
| Autor: | M Geurts, Andrzej P. Wojcieszynski, John E. Bayouth, Michael F. Bassetti, Patrick M. Hill, Zacariah E. Labby, Craig R. Hullett, Paul M. Harari, Stephen A. Rosenberg, R. Adam Bayliss, Andrew M. Baschnagel, Bhudatt R. Paliwal |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Lung Neoplasms Stereotactic body radiation therapy medicine.medical_treatment stereotactic body radiation therapy NSCLC Radiosurgery Linear particle accelerator 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung medicine Humans Cobalt-60 Cobalt Radioisotopes Lung cancer Lung 4DCT medicine.diagnostic_test business.industry Radiotherapy Planning Computer-Assisted Magnetic resonance imaging Radiotherapy Dosage Real-time MRI Articles medicine.disease 4-D computed tomography Magnetic Resonance Imaging Radiation therapy Oncology 030220 oncology & carcinogenesis volumetric modulated Female Radiology Non small cell Radiotherapy Intensity-Modulated business Nuclear medicine Radiotherapy Image-Guided |
| Zdroj: | Technology in Cancer Research & Treatment |
| ISSN: | 1533-0338 1533-0346 |
| Popis: | Purpose: Magnetic resonance imaging–guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging–guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging–guided radiation therapy plans and internal target volume–based plans utilizing volumetric-modulated arc therapy. Materials and Methods: Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging–guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. Results: Planning tumor volumes trended larger for volumetric-modulated arc therapy–based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging–guided plans ( P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% ( P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL ( P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 ( P < .001). Heterogeneity index was comparable between plans, 1.25 versus 1.25 ( P = .98). Conclusion: Magnetic resonance imaging–guided tri-cobalt-60 radiation therapy is capable of delivering lung high-quality stereotactic body radiation therapy plans that are clinically acceptable as compared to volumetric-modulated arc therapy–based plans. Real-time magnetic resonance imaging provides the unique capacity to directly observe tumor motion during treatment for purposes of motion management. |
| Databáze: | OpenAIRE |
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