Additional PET/CT in week 5–6 of radiotherapy for patients with stage III non-small cell lung cancer as a means of dose escalation planning?

Gillham, Charles; Zips, Daniel; Pönisch, Falk; Evers, C.; Enghardt, W.; Abolmaali, Nasreddin; Zöphel, Klaus; Appold, Steffen; Hölscher, Tobias; Steinbach, Jörg; Kotzerke, Jörg; Herrmann, Thomas; Baumann, Michaël

doi:10.1016/j.radonc.2008.05.004

Cited by 70 publications

(51 citation statements)

References 48 publications

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“…Biologically adapted therapy could use altered fractionation, boosting persistent tumor subvolumes or giving targeted pharmaceuticals (8). Progressive disease on interim scans may even prompt an early change to less toxic palliative therapy, avoiding toxicity from futile chemo-RT.…”

Section: Discussionmentioning

confidence: 99%

“…Because molecular changes usually precede the anatomic changes visualized on CT, 18 F-FDG PET/CT is a promising modality for interim response assessment during therapy. Changes in 18 F-FDG uptake may reflect alterations in the tumor microenvironment (5,6) and could facilitate individualized biologically adapted therapy (5,(7)(8)(9). However, the specificity of 18 F-FDG PET may reduce in the presence of 18 F-FDG-avid radiationinduced inflammation in tumor and adjacent organs (4).…”

mentioning

confidence: 99%

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Differential ¹⁸F-FDG and ¹⁸F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

et al. 2014

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Differential ¹⁸F-FDG and ¹⁸F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

et al. 2014

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“…In the current study, the same dose to targets in plan 2 would be limited due to normal tissues exceeding their constraints. Thus tumor shrinkage determined by the second FDG PET/CT during treatment was thought to be beneficial to protect organs at risk and result in improvement on dose escalation, which was also suggested by Gillham (2008). The Radiation Therapy Oncology Group (RTOG) 94-01 trial established that 60 Gy was the optimal dose for local advanced NSCLC, with 4-year survival rate of 21% and median survival rates of approximately 17 months (Curran et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Shrinking Field Radiation Therapy through 18F-FDG PET/CT after 40 Gy for Stage III Non-Small Cell Lung Cancers

Ding¹,

Zhang²,

Li³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/ CT during treatment for patients with stage Ⅲ non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.

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“…The feasibility of boosting areas with residual 18 F-FDG uptake at mid-treatment or later during radiotherapy in NSCLC is, however, controversial. 76,77 Dose painting planning studies in patients with NSCLC have recently been suggested to improve tumour control probability, and clinical studies are being conducted accordingly. [78][79][80] However, so far no reports are available that demonstrate that an increase in dose to hypoxic subvolumes in individual tumours may improve radiotherapy outcome.…”

Section: Functional Bioimage-tailored Radiotherapy For Head and Neck mentioning

confidence: 99%

Validation of functional imaging as a biomarker for radiation treatment response

Jentsch¹,

Beuthien‐Baumann²,

Troost³

et al. 2015

BJR

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Major advances in radiotherapy techniques, increasing knowledge of tumour biology and the ability to translate these advances into new therapeutic approaches are important goals towards more individualized cancer treatment. With the development of non-invasive functional and molecular imaging techniques such as positron emission tomography (PET)-CT scanning and MRI, there is now a need to evaluate potential new biomarkers for tumour response prediction, for treatment individualization is not only based on morphological criteria but also on biological tumour characteristics. The goal of individualization of radiotherapy is to improve treatment outcome and potentially reduce chronic treatment toxicity. This review gives an overview of the molecular and functional imaging modalities of tumour hypoxia and tumour cell metabolism, proliferation and perfusion as predictive biomarkers for radiation treatment response in head and neck tumours and in lung tumours. The current status of knowledge on integration of PET/CT/MRI into treatment management and bioimage-guided adaptive radiotherapy are discussed.

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Additional PET/CT in week 5–6 of radiotherapy for patients with stage III non-small cell lung cancer as a means of dose escalation planning?

Cited by 70 publications

References 48 publications

Differential ¹⁸F-FDG and ¹⁸F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

Differential ¹⁸F-FDG and ¹⁸F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

Feasibility of Shrinking Field Radiation Therapy through 18F-FDG PET/CT after 40 Gy for Stage III Non-Small Cell Lung Cancers

Validation of functional imaging as a biomarker for radiation treatment response

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Additional PET/CT in week 5–6 of radiotherapy for patients with stage III non-small cell lung cancer as a means of dose escalation planning?

Cited by 70 publications

References 48 publications

Differential 18F-FDG and 18F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

Differential 18F-FDG and 18F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

Feasibility of Shrinking Field Radiation Therapy through 18F-FDG PET/CT after 40 Gy for Stage III Non-Small Cell Lung Cancers

Validation of functional imaging as a biomarker for radiation treatment response

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Product

Resources

About

Differential ¹⁸F-FDG and ¹⁸F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer

Differential ¹⁸F-FDG and ¹⁸F-FLT Uptake on Serial PET/CT Imaging Before and During Definitive Chemoradiation for Non–Small Cell Lung Cancer