Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography

Takahashi, Wataru; Yamashita, Hideomi; Kida, Sigeo; Masutani, Yoshitaka; Sakumi, A.; Ohtomo, Kuni; Nakagawa, Keiichi; Haga, Akihiro

doi:10.1016/j.ijrobp.2013.02.019

Cited by 40 publications

(35 citation statements)

References 13 publications

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“…This volume was similar to the volume that was quantified in most UK radiotherapy centres [7]. Similarly, the study by Takahashi and colleagues, which applies 4D-CBCT in treatment to quantify and detect intra-fractional motion errors, concluded that a 0.5 cm PTV volume is adequate for its sample of patients [11] and emphasises that this volume is enough to include all geometric errors [11].…”

Section: Discussionsupporting

confidence: 64%

The Quantification of Intra-Fractional Tumour Motion Errors in Lung Stereotactic Ablative Radiotherapy Patients

Kanbayti¹,

Ghafoor²,

Webster³

et al. 2017

IJMPCERO

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This work aims at quantifying intra-fractional motion errors and evaluating the appropriateness of a Planning Target Volume (PTV) margin for Queen Elizabeth (QE) Hospital's patients. Intra-fractional motion errors were quantified for 29 patients who underwent lung Stereotactic Ablative Radiotherapy (SABR) treatment at the cancer centre of QE Hospital. One hundred thirty post-Cone Beam Computed Tomography (CBCT) scans were collected to calculate these errors. In terms of the adequacy of a PTV margin, the intra-fractional motion errors that were calculated are combined with other geometric errors which were taken from historical audit studies. Then, the combined outcome was compared with the common PTV margin that is delineated by most United Kingdom (UK) oncology centres. The findings of this study showed that the systematic component of intra-fractional motion error is equal to 0.08, 0.08 and 0.08 cm in right/left, superior/anterior and anterior/posterior directions, respectively, While the random component of this error is equal to 0.11, 0.13 and 0.14 cm. In addition to that, a PTV margin of 0.5 cm is the appropriate margin for QE Hospital's patients and this volume is compatible with the common PTV margin that is delineated by the most UK oncology centres. This work concluded that A PTV margin of 0.5 cm is the suitable volume for lung SABR patients at QE Hospital.

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Section: Discussionsupporting

confidence: 64%

The Quantification of Intra-Fractional Tumour Motion Errors in Lung Stereotactic Ablative Radiotherapy Patients

Kanbayti¹,

Ghafoor²,

Webster³

et al. 2017

IJMPCERO

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“…We had used irradiation dose of 48 Gy in 4 fractions (Figure 1). We also used 4D cone beam computed tomography (CT) to evaluate internal target volume and tumor motion just before SBRT, with the result that the margin between the internal target volume and the PTV became narrower [40,41] .…”

Section: Dose-volume Factors For Rp After Sbrtmentioning

confidence: 99%

Radiation pneumonitis after stereotactic radiation therapy for lung cancer

Yamashita

Takahashi

Haga

et al. 2014

WJR

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Stereotactic body radiation therapy (SBRT) has a local control rate of 95% at 2 years for non-small cell lung cancer (NSCLC) and should improve the prognosis of inoperable patients, elderly patients, and patients with significant comorbidities who have early-stage NSCLC. The safety of SBRT is being confirmed in international, multi-institutional Phase Ⅱ trials for peripheral lung cancer in both inoperable and operable patients, but reports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer. Radiation pneumonitis (RP) is one of the most common toxicities of SBRT. Although most post-treatment RP is Grade 1 or 2 and either asymptomatic or manageable, a few cases are severe, symptomatic, and there is a risk for mortality. The reported rates of symptomatic RP after SBRT range from 9% to 28%. Being able to predict the risk of RP after SBRT is extremely useful in treatment planning. A dose-effect relationship has been demonstrated, but suggested dose-volume factors like mean lung dose, lung V20, and/or lung V2.5 differed among the reports. We found that patients who present with an interstitial pneumonitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumonitis after SBRT. At our institution, lung cancer patients with these risk factors have not received SBRT since 2006, and our rate of severe RP after SBRT has decreased significantly since then.

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“…We have performed SBRT using a kind of intensity modulated radiation therapy (IMRT) method called single-arc volumetric modulated arc therapy (VMAT) created by SmartArc (Pinnacle 3 ; Philips Medical Systems B.V., Eindhoven, The Netherlands). VMAT allows reduction of SBRT treatment times for each fraction, but is still limited by the maximum dose rate of a conventional linear accelerator (linac) with a flattened beam (16).…”

Section: Introductionmentioning

confidence: 99%

Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique

et al. 2018

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Abstract. The present study sought to evaluate the impact of the flattening filter-free (FFF) technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy. Its clinical safety and availability were compared with the flattening filter (FF) method. The cases of 65 patients who underwent lung volumetric modulated arc therapy-stereotactic body radiotherapy (VMAT-SBRT) using FF or FFF techniques were reviewed. A total of 55 Gy/4 fractions (fr) was prescribed for peripheral lesions or 56 Gy/7 fr for central lesions. The total monitor units (MU), treatment time, dose to tumors, dose to organs at risk, tumor control (local control rate, overall survival, progression-free survival) and adverse events between cases treated with FF and cases treated with the FFF technique were compared. A total of 35 patients were treated with conventional FF techniques prior to November 2014 and 30 patients were treated with FFF techniques after this date. It was revealed that the beam-on time was significantly shortened by the FFF technique (P<0.01). Other factors were similar for FFF and FF plans in respect to conformity (P=0.95), homogeneity (P=0.20) and other dosimetric values, including total MU and planning target volume/internal target volume coverage. The median follow-up period was 18 months (range, 2-35). One-year local control rates were 97.1 and 90.0% in the FF group and FFF groups, respectively (P=0.33). Grade 3 pneumonitis was observed in 5.8% of FF patients and 3.4% of FFF patients (P=1.00). No other adverse events ≥grade 3 were observed. The results of the study suggest that VMAT-SBRT using the FFF technique shortens the treatment time for lung SBRT while maintaining a high local control rate with low toxicity.

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Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography

Cited by 40 publications

References 13 publications

The Quantification of Intra-Fractional Tumour Motion Errors in Lung Stereotactic Ablative Radiotherapy Patients

The Quantification of Intra-Fractional Tumour Motion Errors in Lung Stereotactic Ablative Radiotherapy Patients

Radiation pneumonitis after stereotactic radiation therapy for lung cancer

Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique

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