Preserving Functional Lung Using Perfusion Imaging and Intensity-Modulated Radiation Therapy for Advanced-Stage Non–Small Cell Lung Cancer
| Autor: | James D. Cox, Joe Y. Chang, Radhe Mohan, Yerko Borghero, Brian P. Yaremko, Thomas Guerrero, Ritsuko Komaki, Yoshiyuki Shioyama, Isis Gayed, William D. Erwin, Melenda Jeter, Siyoung Jang, X. S. Wang, Zhongxing Liao, H. Helen Liu |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Perfusion scanning Single-photon emission computed tomography Radiation Dosage Carcinoma Non-Small-Cell Lung Humans Medicine Distribution (pharmacology) Radiology Nuclear Medicine and imaging Radiation treatment planning Lung cancer Lung Aged Tomography Emission-Computed Single-Photon Radiation medicine.diagnostic_test business.industry Middle Aged medicine.disease respiratory tract diseases Radiation therapy medicine.anatomical_structure Oncology Feasibility Studies Female Radiotherapy Intensity-Modulated Radiology Tomography X-Ray Computed business Nuclear medicine Perfusion |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 68:1349-1358 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2007.02.015 |
| Popis: | Purpose: To assess quantitatively the impact of incorporating functional lung imaging into intensity-modulated radiation therapy planning for locally advanced non-small cell lung cancer (NSCLC). Methods and Materials: Sixteen patients with advanced-stage NSCLC who underwent radiotherapy were included in this study. Before radiotherapy, each patient underwent lung perfusion imaging with single-photon-emission computed tomography and X-ray computed tomography (SPECT-CT). The SPECT-CT was registered with simulation CT and was used to segment the 50- and 90-percentile hyperperfusion lung (F50 lung and F90 lung). Two IMRT plans were designed and compared in each patient: an anatomic plan using simulation CT alone and a functional plan using SPECT-CT in addition to the simulation CT. Dosimetric parameters of the two types of plans were compared in terms of tumor coverage and avoidance of normal tissues. Results: In incorporating perfusion information in IMRT planning, the median reductions in the mean doses to the F50 and F90 lung in the functional plan were 2.2 and 4.2 Gy, respectively, compared with those in the anatomic plans. The median reductions in the percentage of volume irradiated with >5 Gy, >10 Gy, and >20 Gy in the functional plans were 7.1%, 6.0%, and 5.1%, respectively, for F50 lung, and 11.7%, 12.0%,more » and 6.8%, respectively, for F90 lung. A greater degree of sparing of the functional lung was achieved for patients with large perfusion defects compared with those with relatively uniform perfusion distribution. Conclusion: Function-guided IMRT planning appears to be effective in preserving functional lung in locally advanced-stage NSCLC patients.« less |
| Databáze: | OpenAIRE |
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