Feasibility of cone beam CT-guided library of plans strategy in pre-operative gastric cancer radiotherapy
| Autor: | Astrid van der Horst, Margot Bleeker, Maarten C.C.M. Hulshof, Arjan Bel, Jan-Jakob Sonke, K. Goudschaal |
|---|---|
| Přispěvatelé: | Graduate School, Radiotherapy, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, Other Research |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Stomach Neoplasms medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) Adaptive radiotherapy Plan selection Cone beam ct Observer study business.industry Radiotherapy Planning Computer-Assisted Cancer Radiotherapy Dosage Hematology Cone-Beam Computed Tomography Library of plans medicine.disease Cbct imaging Pre operative Radiation therapy Oncology 030220 oncology & carcinogenesis Cancer Radiotherapy Feasibility Studies Radiology Radiotherapy Intensity-Modulated business Gastric cancer Radiotherapy Image-Guided |
| Zdroj: | Radiotherapy and oncology, 149, 49-54. Elsevier Ireland Ltd |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2020.04.057 |
| Popis: | Background and purpose The stomach displays large anatomical changes in size, shape and position, which implies the need for plan adaptation for gastric cancer patients who receive pre-operative radiotherapy. We evaluated the feasibility and necessity of a CBCT-guided library of plans (LoP) strategy in gastric cancer radiotherapy. Methods Eight gastric cancer patients treated with 24–25 fractions of single-plan radiotherapy with daily CBCT imaging were included. The target was delineated on the pre-treatment CT and first 5 CBCTs to create a patient-specific LoP. Plan selections were performed by 12 observers in a training stage (2–3 CBCTs per patient) and an assessment stage (17 CBCTs per patient). The observers were asked to select the smallest plan that encompassed the target on the CBCT. A total of 136 plan selections were evaluated in the assessment stage. Results Delineations on CBCTs showed that in 90% of the 40 delineated fractions part of the CTV was outside the PTV based on the pre-treatment CT. At least two-thirds of the observers agreed on the selected plan in 65.2% and 70% of the fractions in the training stage and the assessment stage, respectively. For each patient, at least two different plans from the LoP were the most selected plan. Conclusion A CBCT-guided patient-specific LoP strategy is feasible for gastric cancer patients, yielding good agreement in plan selections. Unless generous margins are used to avoid frequent geometric misses, it is likely that part of the target will be missed with single-plan radiotherapy. |
| Databáze: | OpenAIRE |
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