PURPOSE: Surgery is the treatment of choice for lung metastases. Radiotherapy can be used for inoperable patients with curative intent. Stereotactic hypofractionated irradiation has been explored in phase I/II trials and seams feasible and effective. Helical Tomotherapy is a novel irradiation modality that permits an accurate set-up verification with its Mega-Voltage Computed Tomography (MV-CT) repositioning system and a highly conformai dose distribution. The aim of this study is to verify the feasibility of hypofractionated 4D-PET/CT-based Helical Tomotherapy for the treatment of patients affected by lung metastases. MATERIALS/METHODS: Seven patients affected by lung metastases were studied. "F-FDG Positron Emission Tomography and Computed Tomography in 4D modality (4D-PET/CT) were used to define target volumes. A dose of 36 Gy/6 fractions/2 weeks was prescribed to be delivered by Helical Tomotherapy. Before each fraction a MV-CT was acquired and co-registered both automatically and manually with reference images to accurately reposition the patient. RESULTS: A good target coverage (Planning Target Volume D95 = 35.71 ± 0.56 Cy) and organ at risk sparing were obtained. Treatment was well tolerated with no acute toxicity. There were 5 assessable patients with a follow up period of 5.41 ± 2.96 months: 2 patients reached a complete response, 2 patients a partial response, 1 patient a stable disease. CONCLUSIONS: Hypofractionated 4D-PET/CT-based Helical Tomotherapy for the treatment of lung metastases is feasible. For further evaluation of this treatment modality a phase I trial of dose escalation has been initiated.
|Translated title of the contribution||Hypofractionated 4D-PET/CT-based Helical Tomotherapy for the treatment of lung metastases: A feasibility study|
|Number of pages||6|
|Publication status||Published - Mar 2007|
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