Étude dosimétrique des différentes techniques de gestion du mouvement respiratoire pour l’irradiation thoracique en conditions stéréotaxiques

Paumier, A.; Crespeau, A.; Krhili, S.; Georgin-Mège, M.; Tuchais, C.; Mesgouez, J.; Cellier, P.; Lisbona, A.; Denis, Fabrice; Autret, D.

doi:10.1016/j.canrad.2012.03.004

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…The irradiated volume is reduced by decreasing tumor movement with BH in SBRT (2)(3)(4). One of the aims of the treatment is that it can be tolerated by the patient and should be applied within an acceptable time interval in the daily work ow.…”

Section: Discussionmentioning

confidence: 99%

“…The breath-hold technique relies on the patient holding their breath during the simulation and treatment to minimize the tumor motion and irradiated normal tissue (2). The reduced motion is associated with a reduced planning target volume (PTV) compared to ITV based approach and so has the potential to improve the doses delivered to the organs at risk (OAR) (3,4). However, reproducibility and consistency during simulation and treatment are critically important.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and Tolerability of Surface Guided Radiotherapy in Breath-Hold Liver Stereotactic Body Radiotherapy

Turna

Kucukmorkoc

Rzazade

et al. 2023

Preprint

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Background: Intra-fractional motion is one of the main challenges in SBRT. Breath-hold (BH) technique minimizes the tumor motion. However, reproducibility and consistency are critically important. Surface tracking systems integrated into treatment enable motion tracking with three-dimensional camera technology. Surface guidance was integrated with Varian EDGE and used at multiple treatment sites since 2018 in our department. After four years of experience, in this study, we aim to publish patient-reported outcomes (PROMs), feasibility, and tolerability of surface guidance (SGRT) with breath-hold SBRT in a specific subgroup: liver metastases. Methods: Patients with liver metastasis treated with breath-hold and SGRT were evaluated prospectively. Two-step, seven-question surveys were applied after CT simulation and treatment. Treatment duration and BH number were recorded. In addition, factors that can affect the SGRT and treatment time were evaluated. Results: Between April 2021- May 2022, 41 patients were treated in 171 fractions. According to the PROMs, previous training was beneficial, and holding breath is tolerable. Patients have a little stress about taking an active role in the treatment. Karnosky performance status (KPS), age, lung volume, or any condition affecting lung capacity, previous BH history, and being a native speaker are not correlated with treatment time and BH with SGRT tolerability. Only female patients have better BH performance with SGRT treatments than male patients (p: 0,02). Conclusion: SGRT applications in BH are tolerable and feasible in liver SBRT treatments. There is no specific subgroup that cannot be tolerated with this method.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility and Tolerability of Surface Guided Radiotherapy in Breath-Hold Liver Stereotactic Body Radiotherapy

Turna

Kucukmorkoc

Rzazade

et al. 2023

Preprint

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“…The extended survival of metastatic patients has magnified the significance of treatment-related side effects [7] . Employing BH techniques in SBRT is one such strategy that has emerged [2] , [3] , [4] . By mitigating tumor movement, BH techniques enhance the precision of radiation delivery, limiting damage to healthy tissues and minimizing potential complications [2] , [3] , [4] .…”

Section: Discussionmentioning

confidence: 99%

“…Employing BH techniques in SBRT is one such strategy that has emerged [2] , [3] , [4] . By mitigating tumor movement, BH techniques enhance the precision of radiation delivery, limiting damage to healthy tissues and minimizing potential complications [2] , [3] , [4] . One of the objectives during the administration of BH treatments is that the patient can comfortably tolerate this intervention and that the entirety of the treatment can be completed within a reasonable and acceptable timeframe within the daily workflow.…”

Section: Discussionmentioning

confidence: 99%

“…The breath-hold technique involves the patient holding their breath during both simulation and treatment sessions to mitigate tumor motion and reduce irradiation of normal tissue [2] . This technique has the potential to decrease the planning target volume (PTV) compared to the internal target volume (ITV) approach, thereby improving the radiation dose delivered to organs at risk (OAR) [3] , [4] . However, ensuring reproducibility and consistency during simulation and treatment sessions is of utmost importance.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and tolerability of breath-hold in liver stereotactic body radiotherapy with surface guided radiotherapy

Turna,

Küçükmorkoç,

Rzazade

et al. 2023

Technical Innovations & Patient Support in Radiation Oncolo

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Can bronchoscopically implanted anchored electromagnetic transponders be used to monitor tumor position and lung inflation during deep inspiration breath‐hold lung radiotherapy?

Harris

Yorke

et al. 2022

Medical Physics

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Purpose To evaluate the efficacy of using bronchoscopically implanted anchored electromagnetic transponders (EMTs) as surrogates for 1) tumor position and 2) repeatability of lung inflation during deep‐inspiration breath‐hold (DIBH) lung radiotherapy. Methods Forty‐one patients treated with either hypofractionated (HF) or conventional (CF) lung radiotherapy on an IRB‐approved prospective protocol using coached DIBH were evaluated for this study. Three anchored EMTs were bronchoscopically implanted into small airways near or within the tumor. DIBH treatment was gated by tracking the EMT positions. Breath‐hold cone‐beam‐CTs (CBCTs) were acquired prior to every HF treatment or weekly for CF patients. Retrospectively, rigid registrations between each CBCT and the breath‐hold planning CT were performed to match to 1) spine, 2) EMTs and 3) tumor. Absolute differences in registration between EMTs and spine were analyzed to determine surrogacy of EMTs for lung inflation. Differences in registration between EMTs and the tumor were analyzed to determine surrogacy of EMTs for tumor position. The stability of the EMTs was evaluated by analyzing the difference between inter‐EMT displacements recorded at treatment from that of the plan for the CF patients, as well as the geometric residual (GR) recorded at the time of treatment. Results A total of 219 CBCTs were analyzed. The average differences between EMT centroid and spine registration among all CBCTs were 0.45±0.42 cm, 0.29±0.28 cm, and 0.18±0.15 cm in superior‐inferior (SI), anterior‐posterior (AP) and lateral directions, respectively. Only 59% of CBCTs had differences in registration < 0.5 cm for EMT centroid compared to spine, indicating that lung inflation is not reproducible from simulation to treatment. The average differences between EMT centroid and tumor registration among all CBCTs were 0.13±0.13 cm, 0.14±0.13 cm and 0.12±0.12 cm in SI, AP and lateral directions, respectively. Ninety‐five percent of CBCTs resulted in a < 0.5 cm change between EMT centroid and tumor registration, indicating that EMT positions correspond well with tumor position during treatments. Six out of the seven recorded CF patients had average differences in inter‐EMT displacements ≤0.26 cm and average GR ≤0.22 cm, indicating that the EMTs are stable throughout treatment. Conclusions Bronchoscopically implanted anchored EMTs are good surrogates for tumor position and are reliable for maintaining tumor position when tracked during DIBH treatment, as long as the tumor size and shape are stable. Large differences in registration between EMTs and spine for many treatments suggest that lung inflation achieved at simulation is often not reproduced.

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Étude dosimétrique des différentes techniques de gestion du mouvement respiratoire pour l’irradiation thoracique en conditions stéréotaxiques

Cited by 9 publications

References 27 publications

Feasibility and Tolerability of Surface Guided Radiotherapy in Breath-Hold Liver Stereotactic Body Radiotherapy

Feasibility and Tolerability of Surface Guided Radiotherapy in Breath-Hold Liver Stereotactic Body Radiotherapy

Feasibility and tolerability of breath-hold in liver stereotactic body radiotherapy with surface guided radiotherapy

Can bronchoscopically implanted anchored electromagnetic transponders be used to monitor tumor position and lung inflation during deep inspiration breath‐hold lung radiotherapy?

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