Quantification of Tumor Volume Changes During Radiotherapy for Non–Small-Cell Lung Cancer

Fox, Jana; Ford, Eric; Redmond, K.J.; Zhou, Jessica; Wong, John; Song, Danny Y.

doi:10.1016/j.ijrobp.2008.07.063

Cited by 105 publications

(81 citation statements)

References 24 publications

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“…Similar results have been obtained before. Fox et al (2009) showed in their study that the GTV had a median reduction of 24.7% at dose of 30 Gy and of 44.3% at dose of 50 Gy. In addition, Guckenberger et al (2011) reported continuous tumor regression by 1.2% per day was measured in CT images of 13 patients treated for NSCLC, which was in very good agreement with the data of Kupelian's research (Kupelian et al, 2005).…”

Section: Discussionmentioning

confidence: 97%

“…Similarly, our result showed that patients receiving concurrent chemoradiotherapy would have more significant reductions in target volumes than those who were treated with radiotherapy alone. However, Fox et al (2009) reported no difference in tumor regression between radiotherapy and chemoradiotherapy. We have only five patients treated with radiotherapy only, thus it needed to be further researched.…”

Section: Discussionmentioning

confidence: 98%

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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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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

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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“…Many trials reported shrinkage in the volume of locally advanced NSCLC during the course of radiation or concomitant chemoradiation [7][8][9][10] . In our study, CT imaging was repeated after 44 Gy and we observed an average reduction in PTV by about 50% which is in agreement with data reported by Britton et al and JuhlerNottrup et al 11,12 .…”

Section: Discussionmentioning

confidence: 99%

Effective Adaptive Radiotherapy for Locally Advanced Lung Cancer Treated with 3D Conformal Technique

Salem

Sayed

Amin

2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background:The reduction in tumor volume during the treatment of locally advanced non-small cell lung cancer (NSCLC) with chemoradiotherapy allows the application of adaptive radiotherapy strategy. Adaptive planning has the potential for improving radiotherapy planning indices and dose escalation while respecting the dose to the organs at risk (OARs). Aim: To evaluate the benefit of adaptive radiotherapy in patients with advanced NSCLC treated with conformal technique. Methods: In this dosimetric planning study, we included computerized tomography data-sets from 10 patients with locally advanced NSCLC who responded to the first 22 fractions (44 Gy) and achieved ˃ 20% regression in gross tumor volume. We designed for each patient two plans. Plan 1 (conventional planning) in which the whole prescribed dose (64 Gy) was delivered to the planning target volume 1 (PTV1). Plan 2 (adaptive planning) was divided into plan 2A delivering 44 Gy to PTV1 and plan 2B delivering 20 Gy to PTV2. In plan 2B we re-delineated the PTV and all the target volumes on the repeated CT images to deliver the rest of the prescribed dose (20 Gy). Plan 2A and Plan 2B were summed to measure the accumulated dose delivered to OARs. Results: The mean PTV2 was significantly smaller than the mean PTV1 (p<0.001) with 53% reduction. Adaptive planning resulted in 13.2% mean reduction in the maximum dose to the spinal cord (p<0.001), 10.4% in esophagus V35 (p<0.001), 11.4% in esophagus V50 (p<0.001), 24.3% in mean lung dose (p=0.001) and 19.7% in lung V20 (p<0.001). The reduction in heart d-max and heart mean dose was not significant. Conclusion:The adaptive radiotherapy technique used in our study can reduce the irradiated volume and minimize the dose delivered to OARs. This simple applicable technique can be easily implemented in limited resources centers.

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“…However, the large tumor volume and low tolerance of surrounding critical organs limit the dose escalation (2). Tumor often regresses during the course of radiotherapy or CRT for NSCLC (3,4), reflecting in anatomy, tumor mobility and volume. Thus individualized shrinking field technique was recommended during treatment (5).…”

Section: Introductionmentioning

confidence: 99%

A Clinical Study of Shrinking Field Radiation Therapy Based on ¹⁸F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer

Ding

Wang

et al. 2013

Technol Cancer Res Treat

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The aim is to investigate the feasibility of shrinking field technique after 40 Gy for stage III nonsmall cell lung cancer (NSCLC) during radiation therapy. Eighty-seven consecutive patients treated with intensity-modulated radiation therapy or three-dimensional conformal radiation therapy were enrolled in this study. months, ranging from 5 to 46 months, and the 1-and 2-year overall survival rates in our study were 74.7% and 34.6%. The response rate was 79.5%, and radiation toxicity was acceptable. Tumor progression occurred in 67.8% (59/87) patients. Numbers of patients who had outfield, infield and both infield and outfield recurrences were 3 (3.4%), 26 (29.5%), and 3 (3.4%), respectively. In conclusion, significant tumor regression was observed after 40 Gy, and radiation dose escalated after shrinking field with acceptable toxicity and outfield relapse. Shrinking field radiotherapy based on 18 F-FDG PET/CT after 40 Gy was safe and feasible for stage III NSCLC.

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Quantification of Tumor Volume Changes During Radiotherapy for Non–Small-Cell Lung Cancer

Cited by 105 publications

References 24 publications

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

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

Effective Adaptive Radiotherapy for Locally Advanced Lung Cancer Treated with 3D Conformal Technique

A Clinical Study of Shrinking Field Radiation Therapy Based on ¹⁸F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer

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Quantification of Tumor Volume Changes During Radiotherapy for Non–Small-Cell Lung Cancer

Cited by 105 publications

References 24 publications

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

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

Effective Adaptive Radiotherapy for Locally Advanced Lung Cancer Treated with 3D Conformal Technique

A Clinical Study of Shrinking Field Radiation Therapy Based on 18F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer

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A Clinical Study of Shrinking Field Radiation Therapy Based on ¹⁸F-FDG PET/CT for Stage III Non-Small Cell Lung Cancer