Dosimetric consequences of breath-hold respiration in conformal radiotherapy of esophageal cancer

Lorchel, F.; Dumas, Jean-Luc; Noël, Alain; Bosset, J.F.; Aletti, P.

doi:10.1016/s1120-1797(06)80047-5

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…However, it did reduce the lung mean dose by 1.33 Gy ( P < 0.001) and V 20 Gy by 2.2% ( P < 0.001) with gating ranging 85–15% in patients with thoracic malignancies. Another study revealed that RGRT with DIBH technique correlated with 32% reduction (19.9% versus 13.5%) in lung V 20 Gy compared to free breathing in patients with esophageal cancer [17]. Our results showed the low dose volume areas of normal liver including V 5 Gy , V 10 Gy , and V 20 Gy , and V 10 Gy received less doses of radiation with the 4D MIP CT than with the free breathing CT in patients with liver cancer.…”

Section: Discussionmentioning

confidence: 51%

“…The dose fractionation schedules were 50 Gy in 5 fractions for the patients with lung cancer and 54 Gy in 18 fractions for those with liver cancer. The conformity index (CI), homogeneity index (HI), and prescription isodose target volume conformal index (PITV) were calculated for the comparison of target coverage [17–19]. For the DVH comparison of normal lung and liver, V 5 Gy (volume receiving 5 Gy), V 10 Gy (volume receiving 10 Gy), V 20 Gy (volume receiving 20 Gy), V 30 Gy (volume receiving 30 Gy), V 40 Gy (volume receiving 40 Gy), and V 50 Gy (volume receiving 50 Gy) were used.…”

Section: Methodsmentioning

confidence: 99%

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Four-Dimensional Computed Tomography Based Respiratory-Gated Radiotherapy with Respiratory Guidance System: Analysis of Respiratory Signals and Dosimetric Comparison

Lee

Kim

Yang

et al. 2014

BioMed Research International

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Purpose. To investigate the effectiveness of respiratory guidance system in 4-dimensional computed tomography (4DCT) based respiratory-gated radiation therapy (RGRT) by comparing respiratory signals and dosimetric analysis of treatment plans. Methods. The respiratory amplitude and period of the free, the audio device-guided, and the complex system-guided breathing were evaluated in eleven patients with lung or liver cancers. The dosimetric parameters were assessed by comparing free breathing CT plan and 4DCT-based 30–70% maximal intensity projection (MIP) plan. Results. The use of complex system-guided breathing showed significantly less variation in respiratory amplitude and period compared to the free or audio-guided breathing regarding the root mean square errors (RMSE) of full inspiration (P = 0.031), full expiration (P = 0.007), and period (P = 0.007). The dosimetric parameters including V 5 Gy, V 10 Gy, V 20 Gy, V 30 Gy, V 40 Gy, and V 50 Gy of normal liver or lung in 4DCT MIP plan were superior over free breathing CT plan. Conclusions. The reproducibility and regularity of respiratory amplitude and period were significantly improved with the complex system-guided breathing compared to the free or the audio-guided breathing. In addition, the treatment plan based on the 4D CT-based MIP images acquired with the complex system guided breathing showed better normal tissue sparing than that on the free breathing CT.

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Section: Discussionmentioning

confidence: 51%

Section: Methodsmentioning

confidence: 99%

Four-Dimensional Computed Tomography Based Respiratory-Gated Radiotherapy with Respiratory Guidance System: Analysis of Respiratory Signals and Dosimetric Comparison

Lee

Kim

Yang

et al. 2014

BioMed Research International

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“…Breathing control could decrease respiratory-induced esophageal tumor movement. Lorchel et al 18 performed a study to confirm the feasibility of breathing control in conformal radiotherapy of esophageal cancer. They found that deep inspiration breath hold and end inspiration breath hold correlated with a 32% and 20% decrease in lung V 20 and a 25% and 17% decrease in cardiac V 40 , respectively, as compared to free breathing.…”

Section: Discussionmentioning

confidence: 99%

“…Breathing control and respiratory gating can decrease the effect of tumor mobility in radiotherapy for thoracic and abdominal tumors, 15 – 18 but these techniques in radiotherapy for middle and distal esophageal cancers were performed at relatively few institutions. The feasibility depends on the strong correlation between the intrafractional tumor motion and respiration variability during the treatment course.…”

Section: Introductionmentioning

confidence: 99%

Correlation of primary middle and distal esophageal cancers motion with surrounding tissues using four-dimensional computed tomography

Wang¹,

Li²,

Zhang³

et al. 2016

OTT

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PurposeTo investigate the correlation of gross tumor volume (GTV) motion with the structure of interest (SOI) motion and volume variation for middle and distal esophageal cancers using four-dimensional computed tomography (4DCT).Patients and methodsThirty-three patients with middle or distal esophageal carcinoma underwent 4DCT simulation scan during free breathing. All image sets were registered with 0% phase, and the GTV, apex of diaphragm, lung, and heart were delineated on each phase of the 4DCT data. The position of GTV and SOI was identified in all 4DCT phases, and the volume of lung and heart was also achieved. The phase relationship between the GTV and SOI was estimated through Pearson’s correlation test.ResultsThe mean peak-to-peak displacement of all primary tumors in the lateral (LR), anteroposterior (AP), and superoinferior (SI) directions was 0.13 cm, 0.20 cm, and 0.30 cm, respectively. The SI peak-to-peak motion of the GTV was defined as the greatest magnitude of motion. The displacement of GTV correlated well with heart in three dimensions and significantly associated with bilateral lung in LR and SI directions. A significant correlation was found between the GTV and apex of the diaphragm in SI direction (rleft=0.918 and rright=0.928). A significant inverse correlation was found between GTV motion and varying lung volume, but the correlation was not significant with heart (rLR=−0.530, rAP=−0.531, and rSI=−0.588) during respiratory cycle.ConclusionFor middle and distal esophageal cancers, GTV should expand asymmetric internal margins. The primary tumor motion has quite good correlation with diaphragm, heart, and lung.

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“…To this end, continuous efforts are aimed at minimizing the dose delivered to organs at risk while maintaining or even maximizing the dose to the target. Recent but widely implemented techniques contributing greatly to conformal dose distribution, particularly in the thorax, include image guidance (IGRT), e.g., using kV imaging and cone beam computed tomography to reduce set-up errors [8,40], techniques which meet concerns of moving targets, e.g., breath-hold techniques [46,79], and gating [55] and intensity-modulated photon radiotherapy (IMRT) [29]. IMRT can improve conformality compared with conformal 3D techniques, especially in cases of geometrically complex targets.…”

Section: Current and Future Strategies Of Radiation Oncology To Reducmentioning

confidence: 99%

Cardiac side effects of conventional and particle radiotherapy in cancer patients

Wittig

Engenhart‐Cabillic

2011

Herz

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Dosimetric consequences of breath-hold respiration in conformal radiotherapy of esophageal cancer

Cited by 15 publications

References 20 publications

Four-Dimensional Computed Tomography Based Respiratory-Gated Radiotherapy with Respiratory Guidance System: Analysis of Respiratory Signals and Dosimetric Comparison

Four-Dimensional Computed Tomography Based Respiratory-Gated Radiotherapy with Respiratory Guidance System: Analysis of Respiratory Signals and Dosimetric Comparison

Correlation of primary middle and distal esophageal cancers motion with surrounding tissues using four-dimensional computed tomography

Cardiac side effects of conventional and particle radiotherapy in cancer patients

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