TY - JOUR
T1 - Impact of a breathing-control system on target margins and normal-tissue sparing in the treatment of lung cancer
T2 - Experience at the radiotherapy unit of Florence University
AU - Scotti, Vieri
AU - Marrazzo, Livia
AU - Saieva, Calogero
AU - Agresti, Benedetta
AU - Meattini, Icro
AU - Desideri, Isacco
AU - Cecchini, Sara
AU - Bertocci, Silvia
AU - Franzese, Ciro
AU - De Luca Cardillo, Carla
AU - Zei, Giacomo
AU - Loi, Mauro
AU - Greto, Daniela
AU - Mangoni, Monica
AU - Bonomo, Pieroluigi
AU - Livi, Lorenzo
AU - Biti, Gian Paolo
PY - 2014
Y1 - 2014
N2 - Purpose: In lung cancer, a high radiation dose to the target area correlates with better local control but is frequently counterbalanced by a higher risk of lung toxicity. Several methods exist to coordinate respiratory motion in lung radiotherapy. We aimed to investigate the impact of a breathing-control system on irradiated volumes and dosimetric parameters in three-dimensional conformal radiotherapy (3D-CRT) and stereotactic radiotherapy (SRT) treatments. Materials and methods: Twelve patients were scheduled for radical radiotherapy: five for SRT and seven for 3DCRT. For each patient, in addition to the free-breathing computed tomography (CT) scan, four additional sets of CT slices were acquired using the Active Breathing Coordinator device (ABC, Elekta Oncology Systems Ltd., UK). Results: The volumes acquired with the ABC device were significantly smaller than the free-breathing volumes [23 % reduction of planning tumour volume (PTV), p = 0.002]. ABC allowed a reduction of all dosimetric parameters [2.28 % reduction of percentage volume of lung treated to a dose of ≥20 Gy (V20), p = 0.004; 10 % reduction of mean lung dose (MLD), p = 0.009]. Significant differences were found both in SRT and in 3D-CRT, in peripheral and apical lesions. Conclusion In our experience, ABC has the potential to reduce lung toxicity in the treatment of lung cancer; alternatively, it can allow the prescribed dose to be increased while maintaining the same risk of lung toxicity.
AB - Purpose: In lung cancer, a high radiation dose to the target area correlates with better local control but is frequently counterbalanced by a higher risk of lung toxicity. Several methods exist to coordinate respiratory motion in lung radiotherapy. We aimed to investigate the impact of a breathing-control system on irradiated volumes and dosimetric parameters in three-dimensional conformal radiotherapy (3D-CRT) and stereotactic radiotherapy (SRT) treatments. Materials and methods: Twelve patients were scheduled for radical radiotherapy: five for SRT and seven for 3DCRT. For each patient, in addition to the free-breathing computed tomography (CT) scan, four additional sets of CT slices were acquired using the Active Breathing Coordinator device (ABC, Elekta Oncology Systems Ltd., UK). Results: The volumes acquired with the ABC device were significantly smaller than the free-breathing volumes [23 % reduction of planning tumour volume (PTV), p = 0.002]. ABC allowed a reduction of all dosimetric parameters [2.28 % reduction of percentage volume of lung treated to a dose of ≥20 Gy (V20), p = 0.004; 10 % reduction of mean lung dose (MLD), p = 0.009]. Significant differences were found both in SRT and in 3D-CRT, in peripheral and apical lesions. Conclusion In our experience, ABC has the potential to reduce lung toxicity in the treatment of lung cancer; alternatively, it can allow the prescribed dose to be increased while maintaining the same risk of lung toxicity.
KW - Active breathing control (ABC)
KW - Internal target volume (ITV)
KW - Lung dose (MLD)
KW - Radiotherapy
KW - Target volumes
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U2 - 10.1007/s11547-013-0307-6
DO - 10.1007/s11547-013-0307-6
M3 - Article
C2 - 24234184
AN - SCOPUS:84898547710
VL - 119
SP - 13
EP - 19
JO - Radiologia Medica
JF - Radiologia Medica
SN - 0033-8362
IS - 1
ER -