Effect of Intrafractional Organ Motion on Intensity-modulated Radiation Therapy Dose Distribution for Lung Cancer: A Quantitative Analysis using Free-form Deformable Registration

Kim, S.; Bae, Hyo-Sang; Oh, Dongryul; Kim, K.; Kang, Sei-Kwon; Cheong, Kwang Ho; Hwang, Tae‐Kon

doi:10.1016/j.ijrobp.2008.06.1850

Cited by 3 publications

(1 citation statement)

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“…With advanced technology such as IMRT, there is concern that motion could affect the dose distribution. In fact, Kim et al have reported that respiratory motion can reduce the delivered dose to lung tumors that move in the range of 1 cm up to 30 % [19]. Motion management strategies should be considered if using IMRT to prevent potential tumor underdosage.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of definitive or preoperative IMRT chemoradiation for esophageal cancer

et al. 2012

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Objectives Intensity-modulated radiation therapy (IMRT) is evolving for the treatment of gastrointestinal cancers. The purpose of this study is to analyze our outcomes utilizing IMRT chemoradiation for esophageal cancer. Methods IMRT was incorporated into esophageal cancer treatment at our center in 2006. Patients treated between 2006 and 2011 with either preoperative or definitive IMRT chemoradiation to 50-60 Gy prescribed to the gross tumor volume and 45-50.4 Gy to the clinical target volume concurrently with chemotherapy were evaluated. IMRT techniques included multifield segmented step and shoot, compensatorbased, and volumetric arc therapy. Overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier and log-rank analysis. Multivariate analysis (MVA) for OS and DFS were performed with a Cox proportional hazard ratio model. Results We identified 108 patients with a median follow-up of 19 months. Median OS and DFS were 32 and 21.6 months, respectively. Fifty-eight (53.7 %) patients underwent surgical resection. There was no difference in OS or DFS in patients who underwent surgery compared to patients treated definitively without surgery. Median weight loss was 5.5 %. Rates of hospital admissions, feeding tube placement, stent placement, dilation, and radiation pneumonitis were 15.7, 7.4 4.6, 12, and 1.9 %, respectively. Long-term radiation pneumonitis was observed in six (5.6 %) patients. MVA revealed that age, stage, and surgery were prognostic for DFS, while gender and histology were not. Gender, histology, and stage were prognostic of OS on MVA, while surgery and age were not. Conclusions IMRT chemoradiation for esophageal cancer is safe and effective when compared to published series of 2D or 3D conformal radiation therapy. This is the largest single institutional series with long-term follow-up, confirming that IMRT is a viable treatment option for the curative treatment of esophageal cancer.

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Section: Discussionmentioning

confidence: 99%