Clinicopathologic Analysis of Microscopic Extension in Lung Adenocarcinoma: Defining Clinical Target Volume for Radiotherapy

Grills, I.S.; Fitch, Dwight L.; Goldstein, Neal S.; Yan, Di; Chmielewski, Gary W.; Welsh, Robert J.; Kestin, Larry L.

doi:10.1016/j.ijrobp.2007.03.023

Cited by 96 publications

(67 citation statements)

References 30 publications

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“…Previous models suggested using a CTV margin of 9 mm. 30 The reduction in visible primary volume may not be representative of what happens to the microscopic disease: does it shrink with this volume or does it stay in the original location. Guckenberger et al 31 described two possible ways of dealing with microscopic disease, including infiltrative growth pattern or an expansive growth pattern.…”

Section: Discussionmentioning

confidence: 99%

An assessment of cone beam CT in the adaptive radiotherapy planning process for non-small-cell lung cancer patients

Duffton

Harrow

McJury

2016

BJR

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Objective: To investigate the potential use of cone beam CT (CBCT) in adaptive radiotherapy (ART) planning process for non-small-cell lung cancer (NSCLC). Methods: 17 retrospective patients with NSCLC Stage T1-T4, who had completed a course of radiotherapy with weekly CBCT imaging were selected for the study. The patients had been delineated and planned for threedimensional (3D) conformal treatment (prescription: 55 Gy in 20 fractions) based on free-breathing fourdimensional CT data. Of these initial 17 patients, 12 had full quantitative data on gross tumour volume (GTV) position and volume throughout treatment. GTV delineation was carried out on weekly CBCT by a clinical oncologist. For each patient, mean percentage change in GTV and centre of mass (COM) displacement (based on 3D vectors) were calculated throughout treatment. Volume overlap between GTVs was calculated. Correlation of the COM displacement and planning GTV (pGTV) was assessed. A linear mixed model with patients as random effects was fitted to the data to assess potential benefit from using ART for these patients. Results: Comparison of CBCT-based GTV acquired prior to Fraction 1 (cbctGTV1) to pGTV showed mean 20 6 19%

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Section: Discussionmentioning

confidence: 99%

An assessment of cone beam CT in the adaptive radiotherapy planning process for non-small-cell lung cancer patients

Duffton

Harrow

McJury

2016

BJR

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“…Grills et al [18] compared the extension of 35 lung tumors in preoperative CT scans with pathological findings. The diameter of the tumor was overestimated by 5.8 mm when the lung window was used and underestimated by 8.5 mm when the soft tissue window was used.…”

Section: Resultsmentioning

confidence: 99%

The importance of surrounding tissues and window settings for contouring of moving targets

et al. 2015

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“…Grills et al [26,27] reported a trend toward reduced local recurrence with SBRT compared to wedge resection (4% following SBRT versus 20% with wedge resection, P ¼ 0.07). No statistical difference was identified between outcomes with SBRT and wedge resection at 30 months, but overall survival was better with wedge resection (87% with wedge resection versus 72% with SBRT, P ¼ 0.01).…”

Section: Discussionmentioning

confidence: 96%

Individualized higher dose of 70–75 Gy using five-fraction robotic stereotactic radiotherapy for non-small-cell lung cancer: A feasibility study

Brown

Fayad²,

Hevezi³

et al. 2011

Computer Aided Surgery

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Objective: To determine whether robotic stereotactic radiotherapy of 70-75 Gy delivered in five fractions results in an improved therapeutic ratio, compared with three fractions, in the treatment of peripheral non-small-cell lung cancer (NSCLC), in which case doses of up to 85 Gy in five fractions may be feasible. Materials and Methods: Between December 2006 and May 2010, 20 patients (9 female, 11 male, aged 65 to 88) were treated using the CyberKnife Õ Robotic Radiosurgery System for NSCLC with doses ranging from 67 Gy to 75 Gy based on location, histopathological type, grade of histopathological differentiation, tumor diameter/volume, and normal tissue constraints, with the doses being delivered in five fractions over 5 to 8 days. Tumor diameters ranged from 1.5 cm to 3.4 cm (median: 2.5 cm). Patients with Stage I to IV NSCLC were treated, and the results and observations were analyzed for clinical characteristics and outcomes including toxicity. All patients, except one who had refused surgery, had co-morbid conditions that precluded a lobectomy. Results: Twenty patients were followed every three months by positron emission tomography/computed tomography (PET/ CT). Mean follow-up was 23 months (range: four to 58 months). Local control was achieved in all treated tumors. Three patients expired, and three developed new regional metastases, none of which was within the planning target volume (PTV). The remainder of the patients demonstrated no evidence of recurrence or continued growth detectable by PET/ CT. There was no toxicity above Grade 1. Conclusions: It is feasible to treat peripheral NSCLC with individualized maximal tolerable doses ranging from 67 Gy to 75 Gy in five fractions chosen on the basis of location, histopathological type, grade of histopathological differentiation, tumor diameter/volume, and normal tissue constraints.

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Clinicopathologic Analysis of Microscopic Extension in Lung Adenocarcinoma: Defining Clinical Target Volume for Radiotherapy

Cited by 96 publications

References 30 publications

An assessment of cone beam CT in the adaptive radiotherapy planning process for non-small-cell lung cancer patients

An assessment of cone beam CT in the adaptive radiotherapy planning process for non-small-cell lung cancer patients

The importance of surrounding tissues and window settings for contouring of moving targets

Individualized higher dose of 70–75 Gy using five-fraction robotic stereotactic radiotherapy for non-small-cell lung cancer: A feasibility study

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