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Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans

PURPOSE: Magnetic resonance imaging–guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motio...

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Autores principales: Wojcieszynski, Andrzej P., Hill, Patrick M., Rosenberg, Stephen A., Hullett, Craig R., Labby, Zacariah E., Paliwal, Bhudatt, Geurts, Mark W., Bayliss, R. Adam, Bayouth, John E., Harari, Paul M., Bassetti, Michael F., Baschnagel, Andrew M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5616053/
https://www.ncbi.nlm.nih.gov/pubmed/28168936
http://dx.doi.org/10.1177/1533034617691407
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author Wojcieszynski, Andrzej P.
Hill, Patrick M.
Rosenberg, Stephen A.
Hullett, Craig R.
Labby, Zacariah E.
Paliwal, Bhudatt
Geurts, Mark W.
Bayliss, R. Adam
Bayouth, John E.
Harari, Paul M.
Bassetti, Michael F.
Baschnagel, Andrew M.
author_facet Wojcieszynski, Andrzej P.
Hill, Patrick M.
Rosenberg, Stephen A.
Hullett, Craig R.
Labby, Zacariah E.
Paliwal, Bhudatt
Geurts, Mark W.
Bayliss, R. Adam
Bayouth, John E.
Harari, Paul M.
Bassetti, Michael F.
Baschnagel, Andrew M.
author_sort Wojcieszynski, Andrzej P.
collection PubMed
description PURPOSE: Magnetic resonance imaging–guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging–guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging–guided radiation therapy plans and internal target volume–based plans utilizing volumetric-modulated arc therapy. MATERIALS AND METHODS: Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging–guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. RESULTS: Planning tumor volumes trended larger for volumetric-modulated arc therapy–based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging–guided plans (P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% (P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL (P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 (P < .001). Heterogeneity index was comparable between plans, 1.25 versus 1.25 (P = .98). CONCLUSION: Magnetic resonance imaging–guided tri-cobalt-60 radiation therapy is capable of delivering lung high-quality stereotactic body radiation therapy plans that are clinically acceptable as compared to volumetric-modulated arc therapy–based plans. Real-time magnetic resonance imaging provides the unique capacity to directly observe tumor motion during treatment for purposes of motion management.
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spelling pubmed-56160532017-10-03 Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans Wojcieszynski, Andrzej P. Hill, Patrick M. Rosenberg, Stephen A. Hullett, Craig R. Labby, Zacariah E. Paliwal, Bhudatt Geurts, Mark W. Bayliss, R. Adam Bayouth, John E. Harari, Paul M. Bassetti, Michael F. Baschnagel, Andrew M. Technol Cancer Res Treat Articles PURPOSE: Magnetic resonance imaging–guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging–guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging–guided radiation therapy plans and internal target volume–based plans utilizing volumetric-modulated arc therapy. MATERIALS AND METHODS: Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging–guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. RESULTS: Planning tumor volumes trended larger for volumetric-modulated arc therapy–based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging–guided plans (P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% (P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL (P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 (P < .001). Heterogeneity index was comparable between plans, 1.25 versus 1.25 (P = .98). CONCLUSION: Magnetic resonance imaging–guided tri-cobalt-60 radiation therapy is capable of delivering lung high-quality stereotactic body radiation therapy plans that are clinically acceptable as compared to volumetric-modulated arc therapy–based plans. Real-time magnetic resonance imaging provides the unique capacity to directly observe tumor motion during treatment for purposes of motion management. SAGE Publications 2017-02-07 2017-06 /pmc/articles/PMC5616053/ /pubmed/28168936 http://dx.doi.org/10.1177/1533034617691407 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Articles
Wojcieszynski, Andrzej P.
Hill, Patrick M.
Rosenberg, Stephen A.
Hullett, Craig R.
Labby, Zacariah E.
Paliwal, Bhudatt
Geurts, Mark W.
Bayliss, R. Adam
Bayouth, John E.
Harari, Paul M.
Bassetti, Michael F.
Baschnagel, Andrew M.
Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
title Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
title_full Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
title_fullStr Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
title_full_unstemmed Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
title_short Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans
title_sort dosimetric comparison of real-time mri-guided tri-cobalt-60 versus linear accelerator-based stereotactic body radiation therapy lung cancer plans
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5616053/
https://www.ncbi.nlm.nih.gov/pubmed/28168936
http://dx.doi.org/10.1177/1533034617691407
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