Radiotherapy for lung cancer: target splitting by asymmetric collimation enables reduction of radiation doses to normal tissues and dose escalation

NSCLC: Primary Tumor Size – Radiation Dose-related Accelerated, Twice Daily Radiotherapy by Target Splitting, Preceded by 2 Cycles of Chemotherapy – First Results of a Prospective Study

“…For the majority of patients the conformal target splitting technique has been employed [13]. The target is split into a cranial and a caudal part; beam arrangements in the two parts are completely independent.…”

Non-Small Cell Lung Cancer in Stages I–IIIB

“…In the majority of the patients, the target-splitting technique was used [1,24,26,29,32], as described in detail previousgionäre 2-Jahres-Tumorkontrollrate liegt bei 49%. Ein Patient verstarb infolge einer Pneumonitis, ansonsten war die Toxizität gemessen an den EORTC/RTOG-Scoring-Kriterien moderat: Pneumonitis Grad 2 (n = 7), Grad 3 (n = 3); Ösophagus Grad 1 (n = 11); Herz Grad 3 (n = 1, Perikarditis; Tabelle 3).…”

“…Schlüsselwörter: Nichtkleinzelliges Bronchialkarzinom · Strahlentherapie · Konformale Radiotherapie · "Target splitting" · Dosiseskalation ly [9,29,32]. Briefly, in an individually chosen transverse plane, the target is split into a cranial and a caudal volume, enabling the design of completely independent beam arrangements for either part.…”

“…Safe application of high-dose treatments demands sophisticated technical solutions. The conformal target-splitting technique was implemented in 1995, thus enabling dose escalations for nonresected NSCLC patients, considering dose constraints as described below [29,32]. The vast majority was treated with doses > 80 Gy.…”

Treatment of Inoperable Stage III and IV Non-Small-Cell Lung Cancer: The ‘Average’Radiotherapist’s Point of View

“…In some studies, dose escalation has a positive impact on tumor control; promising results have been reported by Armstrong et al [6] from the 3D conformal RT for NSCLC (median dose 70.2 Gy); the authors propose that an increase of the total dose results in a better outcome (MST 15.7 months, and a 2-year survival rate of 32%). 3D conformal RT demands for high-tec equipment, although in some centers special techniques have been developed; Wurstbauer et al [7] described an interesting technique (target splitting by asymmetric collimation) which can be easily applied by departments where 3D planning systems are not available. Indication exists that some subtypes of NSCLC proliferate rapidly with a potential doubling time of about 5 days.…”