Functional Image-Guided Radiotherapy Planning in Respiratory- Gated Intensity-Modulated Radiation Therapy (IMRT) for Lung Cancer Patients with chronic obstructive pulmonary disease (COPD)

International Journal of Radiation Oncology, Biology, Physics Volume 82 Issue 4 Page e663-e670 published_at 2012-03-15
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Title ( eng )
Functional Image-Guided Radiotherapy Planning in Respiratory- Gated Intensity-Modulated Radiation Therapy (IMRT) for Lung Cancer Patients with chronic obstructive pulmonary disease (COPD)
Creator
Nishibuchi Ikuno
Murakami Yuji
Kenjo Masahiro
Kaneyasu Yuko
Source Title
International Journal of Radiation Oncology, Biology, Physics
Volume 82
Issue 4
Start Page e663
End Page e670
Abstract
(Purpose) To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD).
(Materials and Methods) Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values lower than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fr) were designed and compared in each patient as follows: 1) Plan A: anatomical IMRTor VMAT plan based on the total lung 2) Plan F: functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (V20: the percentage of total lung volume irradiated with ≥ 20 Gy,MLD:mean dose of total lung) of the two plans were compared.
(Results) V20 was lower in Plan F than in Plan A (mean 1.5 %, p= 0.025 in IMRT, mean 1.6 %, p= 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p= 0.083 in IMRT, mean 0.5 Gy, p= 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses.
(Conclusions) Functional image-guided radiotherapy planning based on LAAin respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.
Keywords
functional imaging
4D-CT
IMRT
COPD
Descriptions
This work was supported in part by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant no. 22591385), and a Grant-in-Aid for Scientific Research from the Association for Nuclear Technology in Medicine.
This work was partly presented at the 52nd Annual Meeting of the American Society of Radiation Oncology, San Diego, CA, Oct 31 - Nov 4, 2010.
NDC
Medical sciences [ 490 ]
Language
eng
Resource Type journal article
Publisher
Elsevier Inc.
Date of Issued 2012-03-15
Rights
Copyright (c) 2012. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
Publish Type Author’s Original
Access Rights open access
Source Identifier
[ISSN] 0360-3016
[ISSN] 1879-355X
[NCID] AA11531004
[DOI] 10.1016/j.ijrobp.2011.08.016
[PMID] 22245191
[DOI] https://doi.org/10.1016/j.ijrobp.2011.08.016