Tumor volume changes on serial imaging with megavoltage CT for non–small-cell lung cancer during intensity-modulated radiotherapy: How reliable, consistent, and meaningful is the effect?

Siker, Malika L.; Tomé, Wolfgang A.; Mehta, Minesh P.

doi:10.1016/j.ijrobp.2006.03.064

Cited by 105 publications

(93 citation statements)

References 16 publications

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“…The GTV changes noted by Kupelian et al (10) are greater than the results reported here (22). However, our study shows greater marginal response and less stable disease than the study by Siker et al (11). In part, this is because complete data from Siker et al (11) include a mixture of treatment strategies: patients treated palliatively and with extracranial stereotactic radioablation.…”

Section: Discussioncontrasting

confidence: 64%

“…However, our study shows greater marginal response and less stable disease than the study by Siker et al (11). In part, this is because complete data from Siker et al (11) include a mixture of treatment strategies: patients treated palliatively and with extracranial stereotactic radioablation. Our study included only patients treated with conventional definitive treatment (see Table 1), and when the palliative and extracranial stereotactic radioablation patient groups are excluded from the data from Siker et al (11), there is better agreement with our study (see Siker* column in Table 4).…”

Section: Discussionmentioning

confidence: 44%

“…In part, this is because complete data from Siker et al (11) include a mixture of treatment strategies: patients treated palliatively and with extracranial stereotactic radioablation. Our study included only patients treated with conventional definitive treatment (see Table 1), and when the palliative and extracranial stereotactic radioablation patient groups are excluded from the data from Siker et al (11), there is better agreement with our study (see Siker* column in Table 4). Total doses in this study are weeks, whereas the patients treated radically in our study were treated during a mean time of 7 weeks, ranging from 3.5-9 weeks.…”

Section: Discussionmentioning

confidence: 99%

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Adaptive Radiotherapy Planning on Decreasing Gross Tumor Volumes as Seen on Megavoltage Computed Tomography Images

Woodford

Yartsev

Dar

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

159

155

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Purpose: To evaluate gross tumor volume (GTV) changes for patients with non-small-cell lung cancer by using daily megavoltage (MV) computed tomography (CT) studies acquired before each treatment fraction on helical tomotherapy and to relate the potential benefit of adaptive image-guided radiotherapy to changes in GTV. Methods and Materials: Seventeen patients were prescribed 30 fractions of radiotherapy on helical tomotherapy for non-small-cell lung cancer at London Regional Cancer Program from Dec 2005 to March 2007. The GTV was contoured on the daily MVCT studies of each patient. Adapted plans were created using merged MVCT-kilovoltage CT image sets to investigate the advantages of replanning for patients with differing GTV regression characteristics.Results: Average GTV change observed over 30 fractions was À38%, ranging from À12 to À87%. No significant correlation was observed between GTV change and patient's physical or tumor features. Patterns of GTV changes in the 17 patients could be divided broadly into three groups with distinctive potential for benefit from adaptive planning. Conclusions: Changes in GTV are difficult to predict quantitatively based on patient or tumor characteristics. If changes occur, there are points in time during the treatment course when it may be appropriate to adapt the plan to improve sparing of normal tissues. If GTV decreases by greater than 30% at any point in the first 20 fractions of treatment, adaptive planning is appropriate to further improve the therapeutic ratio. Ó 2007 Elsevier Inc.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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Adaptive Radiotherapy Planning on Decreasing Gross Tumor Volumes as Seen on Megavoltage Computed Tomography Images

Woodford

Yartsev

Dar

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

159

155

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“…Similar results of tumor repression have been observed by Guckenberger et al who reported a continuous tumor regression by 1.2% per day 7 . In contrast, Siker et al reported no clinically significant tumor regression in their series; however they used hypofractionated irradiation in their study 13 .…”

Section: Discussionmentioning

confidence: 84%

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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“…These images are used to provide image guided radiotherapy (IGRT) imaging the target volume to allow adjustment of the patient to optimize treatment. These images potentially includes information about treatment response [2], [3]. But the quantity (up to 30 fractions per patient) of these images makes manual contouring of gross tumor volume (GTV) unfeasible for clinics.…”

Section: Introductionmentioning

confidence: 99%

Lung Tumor Segmentation Using Electric Flow Lines for Graph Cuts

Hollensen

Cannon

et al. 2012

Lecture Notes in Computer Science

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Abstract. Lung cancer is the most common cause of cancer-related death. A common treatment is radiotherapy where the lung tumors are irradiated with ionizing radiation. The treatment is typically fractionated, i.e. spread out over time, allowing healthy tissue to recover between treatments and allowing tumor cells to be hit in their most sensitive phase. Changes in tumors over the course of treatment allows for an adaptation of the radiotherapy plan based on 3D computer tomography imaging. This paper introduces a method for segmentation of lung tumors on consecutive computed tomography images. These images are normally only used for correction of movements. The method uses graphs based on electric ow lines. The method o ers several advantages when trying to replicate manual segmentations. The method gave a dice coecient of 0.85 and performed better than level set methods and deformable registration.

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Tumor volume changes on serial imaging with megavoltage CT for non–small-cell lung cancer during intensity-modulated radiotherapy: How reliable, consistent, and meaningful is the effect?

Cited by 105 publications

References 16 publications

Adaptive Radiotherapy Planning on Decreasing Gross Tumor Volumes as Seen on Megavoltage Computed Tomography Images

Adaptive Radiotherapy Planning on Decreasing Gross Tumor Volumes as Seen on Megavoltage Computed Tomography Images

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

Lung Tumor Segmentation Using Electric Flow Lines for Graph Cuts

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