Cargando…

Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience

INTRODUCTION: For patients receiving radiotherapy for locally advance non–small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the abilit...

Descripción completa

Detalles Bibliográficos
Autores principales: Livingston, Gareth C., Last, Andrew J., Shakespeare, Thomas P., Dwyer, Patrick M., Westhuyzen, Justin, McKay, Michael J., Connors, Lisa, Leader, Stephanie, Greenham, Stuart
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016614/
https://www.ncbi.nlm.nih.gov/pubmed/27648281
http://dx.doi.org/10.1002/jmrs.159
_version_ 1782452593534959616
author Livingston, Gareth C.
Last, Andrew J.
Shakespeare, Thomas P.
Dwyer, Patrick M.
Westhuyzen, Justin
McKay, Michael J.
Connors, Lisa
Leader, Stephanie
Greenham, Stuart
author_facet Livingston, Gareth C.
Last, Andrew J.
Shakespeare, Thomas P.
Dwyer, Patrick M.
Westhuyzen, Justin
McKay, Michael J.
Connors, Lisa
Leader, Stephanie
Greenham, Stuart
author_sort Livingston, Gareth C.
collection PubMed
description INTRODUCTION: For patients receiving radiotherapy for locally advance non–small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the ability to reduce planned doses to healthy organs at risk (OAR) and can potentially reduce treatment‐related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three‐dimensional conformal radiotherapy (3DCRT). METHODS: Thirty curative NSCLC patients received radiotherapy using four‐dimensional computed tomography and five‐field IMRT. All were assessed for early and late toxicity using common terminology criteria for adverse events. All plans were subsequently re‐planned using 3DCRT to the same standard as the clinical plans. Dosimetric parameters for lungs, oesophagus, heart and conformity were recorded for comparison between the two techniques. RESULTS: IMRT plans achieved improved high‐dose conformity and reduced OAR doses including lung volumes irradiated to 5–20 Gy. One case each of oesophagitis and erythema (3%) were the only Grade 3 toxicities. Rates of Grade 2 oesophagitis were 40%. No cases of Grade 3 RP were recorded and Grade 2 RP rates were as low as 3%. CONCLUSION: IMRT provides a dosimetric benefit when compared to 3DCRT. While the clinical benefit appears to increase with increasing target size and increasing complexity, IMRT appears preferential to 3DCRT in the treatment of NSCLC.
format Online
Article
Text
id pubmed-5016614
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-50166142016-09-19 Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience Livingston, Gareth C. Last, Andrew J. Shakespeare, Thomas P. Dwyer, Patrick M. Westhuyzen, Justin McKay, Michael J. Connors, Lisa Leader, Stephanie Greenham, Stuart J Med Radiat Sci Original Articles INTRODUCTION: For patients receiving radiotherapy for locally advance non–small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the ability to reduce planned doses to healthy organs at risk (OAR) and can potentially reduce treatment‐related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three‐dimensional conformal radiotherapy (3DCRT). METHODS: Thirty curative NSCLC patients received radiotherapy using four‐dimensional computed tomography and five‐field IMRT. All were assessed for early and late toxicity using common terminology criteria for adverse events. All plans were subsequently re‐planned using 3DCRT to the same standard as the clinical plans. Dosimetric parameters for lungs, oesophagus, heart and conformity were recorded for comparison between the two techniques. RESULTS: IMRT plans achieved improved high‐dose conformity and reduced OAR doses including lung volumes irradiated to 5–20 Gy. One case each of oesophagitis and erythema (3%) were the only Grade 3 toxicities. Rates of Grade 2 oesophagitis were 40%. No cases of Grade 3 RP were recorded and Grade 2 RP rates were as low as 3%. CONCLUSION: IMRT provides a dosimetric benefit when compared to 3DCRT. While the clinical benefit appears to increase with increasing target size and increasing complexity, IMRT appears preferential to 3DCRT in the treatment of NSCLC. John Wiley and Sons Inc. 2016-02-15 2016-09 /pmc/articles/PMC5016614/ /pubmed/27648281 http://dx.doi.org/10.1002/jmrs.159 Text en © 2016 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Livingston, Gareth C.
Last, Andrew J.
Shakespeare, Thomas P.
Dwyer, Patrick M.
Westhuyzen, Justin
McKay, Michael J.
Connors, Lisa
Leader, Stephanie
Greenham, Stuart
Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience
title Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience
title_full Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience
title_fullStr Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience
title_full_unstemmed Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience
title_short Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience
title_sort toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4dct and image‐guided intensity modulated radiotherapy: a regional centre's experience
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016614/
https://www.ncbi.nlm.nih.gov/pubmed/27648281
http://dx.doi.org/10.1002/jmrs.159
work_keys_str_mv AT livingstongarethc toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT lastandrewj toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT shakespearethomasp toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT dwyerpatrickm toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT westhuyzenjustin toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT mckaymichaelj toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT connorslisa toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT leaderstephanie toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience
AT greenhamstuart toxicityanddosimetricanalysisofnonsmallcelllungcancerpatientsundergoingradiotherapywith4dctandimageguidedintensitymodulatedradiotherapyaregionalcentresexperience