A CT-assisted method of dosimetry in brachytherapy of lung cancer

Autor: Frank J. Lagerwaard, Connie de Pan, Lars H.P. Murrer, Suresh Senan, Sjaak Burgers, Dick Sipkema
Přispěvatelé: Radiation Oncology, Pulmonary Medicine, CCA - Cancer biology and immunology, CCA - Cancer Treatment and quality of life
Rok vydání: 2000
Předmět:
Zdroj: Radiotherapy and Oncology, 55, 75-80. Elsevier Ireland Ltd
Radiotherapy and Oncology, 55(1), 75-80. Elsevier Ireland Ltd
Senan, S, Lagerwaard, F J, De Pan, C, Sipkema, D, Burgers, S A & Murrer, L H P 2000, ' A CT-assisted method of dosimetry in brachytherapy of lung cancer ', Radiotherapy and Oncology, vol. 55, no. 1, pp. 75-80 . https://doi.org/10.1016/S0167-8140(00)00157-2
ISSN: 0167-8140
DOI: 10.1016/S0167-8140(00)00157-2
Popis: Background: The toxicity of endobronchial brachytherapy (EB), in particular fatal haemoptysis and bronchial wall necrosis, has been correlated with the total dose, fraction size, volume encompassed by the 100% isodose, and a proximal tumor location. We describe a CT-based planning method which, by improving target volume definition and volumetric dose information, can improve the therapeutic ratio of EB. Materials and methods: Sixteen CT-assisted EB procedures were performed in patients who were treated with palliative high-dose rate EB. The CT data were used to analyze applicator position in relation to anatomy. An example of a three-dimensional optimized treatment plan was generated and analyzed using different types of dose-volume histograms. Results: The procedure was well tolerated by patients and no post-procedure complications were observed. The bronchial applicator was eccentrically positioned at the level of the carina/mainstem bronchus in 12 (of 14) CT scans. A planning CT prior to EB was not found to be useful as the final target volume and/or the final applicator position were not reliably predicted before the therapeutic bronchoscopy. CT-scans performed with the applicator in situ allowed the bronchial segments in the target volume to be identified and enabled dose prescription to the bronchial mucosa. Conclusions: CT-assisted EB is feasible and underlines the need for using centered applicators for proximally located tumors. By enabling accurate mucosal dose prescription, CT-assisted EB may reduce the toxicity of fractionated EB in the curative setting. However, faster on-line EB treatment planning is needed for the routine clinical application of this technique. Copyright (C) 2000 Elsevier Science Ireland Ltd.
Databáze: OpenAIRE
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