Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Determining the Optimal Dose Prescription for the Planning Target Volume with Stereotactic Body Radiotherapy for Non-Small Cell Lung Cancer Patients

  • Liu, Xi-Jun (Departments of Radiation Oncology, Shandong University School of Medicine, Shandong Cancer Hospital and Institute) ;
  • Lin, Xiu-Tong (Departments of Medical Physics, Shandong Cancer Hospital and Institute) ;
  • Yin, Yong (Departments of Medical Physics, Shandong Cancer Hospital and Institute) ;
  • Chen, Jin-Hu (Departments of Medical Physics, Shandong Cancer Hospital and Institute) ;
  • Xing, Li-Gang (Departments of Radiation Oncology, Shandong Cancer Hospital and Institute) ;
  • Yu, Jin-Ming (Departments of Radiation Oncology, Shandong Cancer Hospital and Institute)
  • Published : 2016.05.01
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study was to determine a method of dose prescription that minimizes normal tissue irradiation outside the planning target volume (PTV) during stereotactic body radiotherapy (SBRT) for patients with non-small cell lung cancer. Methods: Previous research and patients with typical T1 lung tumors with peripheral lesions in the lung were selected for analysis. A PTV and several organs at risk (OARs) were constructed for the dose calculated; six treatment plans employing intensity modulated radiotherapy (IMRT) were produced, in which the dose was prescribed to encompass the PTV, with the prescription isodose level (PIL) set at 50, 60, 70, 80, 90 or 95% of the isocenter dose. Additionally, four OARs around the PTV were constructed to evaluate the dose received in adjacent tissues. Results: The use of higher PILs for SBRT resulted in improved sparing of OARs, with the exception of the volume of lung treated with a lower dose. Conclusions: The use of lower PILs is likely to create significant inhomogeneity of the dose delivered to the target, which may be beneficial for the control of tumors with poor conformity indices.

Keywords

References

  1. Balagamwala EH, Suh JH, Barnett GH, et al (2012). The importance of the conformality, heterogeneity, and gradient indices in evaluating Gamma Knife radiosurgery treatment plans for intracranial meningiomas. Int J Radiat Oncol Biol Phys, 83, 1406-13. https://doi.org/10.1016/j.ijrobp.2011.10.024
  2. Beitler JJ, Badine EA, El-Sayah D, et al (2006). Stereotactic body radiation therapy for nonmetastatic lung cancer: An analysis of 75 patients treated over 5 years. Int J Radiat Oncol Biol Phys, 65, 100-6. https://doi.org/10.1016/j.ijrobp.2005.11.028
  3. Blomgren H, Lax I, Naslund I, et al (1995). Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator: Clinical experience of the first thirty-one patients. Acta Oncol, 34, 861-70. https://doi.org/10.3109/02841869509127197
  4. Cao D, Holmes T and Afgan M, et al (2007). Comparison of plan quality provided by intensity modulated arc therapy and helical tomotherapy. Int J Radiat Oncol Biol Phys, 69, 240-50. https://doi.org/10.1016/j.ijrobp.2007.04.073
  5. Cardinale RM, Wu Q, Benedict SH, et al (1999). Determining the optimal block margin on the planning target volume for extracranial stereotactic radiotherapy. Int J Radiat Oncol Biol Phys, 45, 515-20. https://doi.org/10.1016/S0360-3016(99)00203-5
  6. Chang JY, Balter PA, Dong L, et al (2008). Stereotactic body radiation therapy in centrally and superiorly located stage I or isolated recurrent non-small-cell lung cancer. Int J Radiat Oncol Biol Phys, 72, 967-71. https://doi.org/10.1016/j.ijrobp.2008.08.001
  7. Cui L, Liu XX, Jiang Y, et al (2014). Phase II study on dose escalating schedule of paclitaxel concurrent with radiotherapy in treating patients with locally advanced non-small cell lung cancer. Asian Pac J Cancer Prev, 15, 1699-702. https://doi.org/10.7314/APJCP.2014.15.4.1699
  8. Fenwick J, Tome W, Soisson E, et al (2006). Tomotherapy and other innovative IMRT systems. Semin Radiat Oncol, 16, 199-208. https://doi.org/10.1016/j.semradonc.2006.04.002
  9. Guckenberger M, Wilbert J, Krieger T, et al (2007). Four-dimensional treatment planning for stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys, 69, 276-85. https://doi.org/10.1016/j.ijrobp.2007.04.074
  10. Hof H, Herfarth KK, Munter M, et al (2003). Stereotactic single-dose radiotherapy of stage I non-small-cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys, 56, 335-41. https://doi.org/10.1016/S0360-3016(02)04504-2
  11. Ji ZQ, Huang XE, Wu XY, et al (2003). Safety of Brucea javanica and cantharidin combined with chemotherapy for treatment of NSCLC patients. Asian Pac J Cancer Prev, 15, 8603-5.
  12. Jin L, WangL, Li J et al. (2007). Investigation of optimal beam margins for stereotactic radiotherapy of lung-cancer using Monte Carlo dose calculations. Phys Med Biol, 52, 3549-3561 https://doi.org/10.1088/0031-9155/52/12/014
  13. Koto M, Takai Y, Ogawa Y, et al (2007). A phase II study on stereotactic body radiotherapy for stage I non-small cell lung cancer. Radiother Oncol, 85, 429-34. https://doi.org/10.1016/j.radonc.2007.10.017
  14. Lagerwaard FJ, Haasbeek CJ, Smit EF, et al (2008). Outcomes of riskadapted fractionated stereotactic radiotherapy for stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys, 70, 685-692. https://doi.org/10.1016/j.ijrobp.2007.10.053
  15. Lee SW, Choi EK, Park HJ, et al (2003). Stereotactic body frame based fractionated radiosurgery on consecutive days for primary or metastatic tumors in the lung. Lung Cancer, 40, 309-15. https://doi.org/10.1016/S0169-5002(03)00040-0
  16. Li Y, Huang XE (2015). A Pooled Analysis on Crizotinib in Treating Chinese Patients with EML4-ALK Positive Non-small-cell Lung Cancer. Asian Pac J Cancer Prev, 16, 4797-800. https://doi.org/10.7314/APJCP.2015.16.11.4797
  17. Liu YC, Zhou SB, Gao F, et al (2013). Chemotherapy and late course three dimensional conformal radiotherapy for treatment of patients with stage III non-small cell lung cancer. Asian Pac J Cancer Prev, 14, 2663-65. https://doi.org/10.7314/APJCP.2013.14.4.2663
  18. Malik Ps, Malik A, Deo SV, et al (2014). Underutilization of curative treatment among patients with non-small cell lung cancer: experience from a tertiary care center in India. Asian Pac J Cancer Prev, 15, 2875-78. https://doi.org/10.7314/APJCP.2014.15.6.2875
  19. McGarry RC, Papiez L, Williams M, et al (2005). Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study. Int J Radiat Oncol Biol Phys, 63, 1010-5. https://doi.org/10.1016/j.ijrobp.2005.03.073
  20. Navarria P, Ascolese AM, Mancosu P, et al (2013). Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non-small cell lung cancer (NSCLC). Radiother Oncol, 3, 414-8.
  21. Nyman J, Johansson KA and Hulten U (2006). Stereotactic hypofractionated radiotherapy for stage I non-small cell lung cancer-Mature results for medically inoperable patients. Lung Cancer, 51, 97-103. https://doi.org/10.1016/j.lungcan.2005.08.011
  22. Ohtakara K, Hayashi S and Hoshi H (2012). The relation between various conformity indices and the influence of the target coverage difference in prescription isodose surface on these values in intracranial stereotactic radiosurgery. Br J Radiol, 85, e223-8. https://doi.org/10.1259/bjr/36606138
  23. Onishi H, Kuriyama K, Komiyama T, et al (2004). Clinical outcomes of stereotactic radiotherapy for stage I non-small cell lung cancer using a novel irradiation technique: Patient self-controlled breath-hold and beam switching using a combination of linear accelerator and CT scanner. Lung Cancer, 45, 45-55. https://doi.org/10.1016/j.lungcan.2004.01.004
  24. Parashar B, Singh P, Christos P, et al (2013). Stereotactic body radiation therapy (SBRT) for early stage lung cancer delivers clinically significant radiation to the draining lymph nodes. J Radiosurg SBRT, 4, 339-340.
  25. Rosen LR, Fischer-Valuck BW, Katz SR, et al (2014). Helical image-guided stereotactic body radiotherapy (SBRT) for the treatment of early-stage lung cancer: a single-institution experience at the Willis-Knighton Cancer Center. Tumori, 1, 42-8.
  26. Salguero FJ, Belderbos JS, Rossi MM, et al (2013). Microscopic disease extensions as a risk factor for loco-regional recurrence of NSCLC after SBRT. Radiother Oncol, 109, 26-31. https://doi.org/10.1016/j.radonc.2013.08.028
  27. Shi B, Zhang XB, Xu J, et al (2015). Systematic Analysis of Icotinib Treatment for Patients with Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev, 16, 5521-4. https://doi.org/10.7314/APJCP.2015.16.13.5521
  28. Uematsu M, Shioda A, Suda A, et al (2001). Computed tomographyguided frameless stereotactic radiotherapy for stage I non-small cell lung cancer: A 5-year experience. Int J Radiat Oncol Biol Phys, 51, 666-70. https://doi.org/10.1016/S0360-3016(01)01703-5
  29. Van Baardwijk A, Tome WA, Van Elmpt W, et al (2012). Is high-dose stereotactic body radiotherapy (SBRT) for stage I non-small cell lung cancer (NSCLC) overkill? A systematic review. Radiother Oncol, 105, 145-9. https://doi.org/10.1016/j.radonc.2012.09.008
  30. Vrdoljak E, Prskalo T, Omrcen T, et al (2005). Concomitant chemobrachy radiotherapy with ifosfamide and cisplatin followed by consolidation chemotherapy in locally advanced squamous cell carcinoma of the uterine cerix. Results of a phase II study. Int J Radiat Oncol Biol Phys, 61, 824-9. https://doi.org/10.1016/j.ijrobp.2004.06.248
  31. Wala J, Salari E, Chen W, et al (2012). Optimal partial-arcs in VMAT treatment planning. Phys Med Biol Sep, 57, 5861-74. https://doi.org/10.1088/0031-9155/57/18/5861
  32. Wang LJ, Liu XJ, Guan Y, et al (2014). Optimal timing of radiotherapy with alternating/sequential radio-chemotherapy for limited-stage small cell lung cancer. Asian Pac J Cancer Prev, 14, 5697-9.
  33. Widder J, Hollander M, Ubbels JF, et al (2010). Optimizing dose prescription in stereotactic body radiotherapy for lung tumors using Monte Carlo dose calculation. Radiother Oncol, 94, 42-4. https://doi.org/10.1016/j.radonc.2009.11.008
  34. Wulf J, Baier K, Mueller G, et al (2005). Dose-response in stereotactic irradiation of lung tumors. Radiother Oncol, 77, 83-7. https://doi.org/10.1016/j.radonc.2005.09.003
  35. Wulf J, Haedinger U, Oppitz U, et al (2004). Stereotactic radiotherapy for primary lung cancer and pulmonary metastases: A noninvasive treatment approach in medically inoperable patients. Int J Radiat Oncol Biol Phys, 60, 186-96. https://doi.org/10.1016/j.ijrobp.2004.02.060
  36. Xia T, Li H, Sun Q, et al (2006). Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable Stage I/II non-small-cell lung cancer. Int J Radiat Oncol Biol Phys, 66, 117-25. https://doi.org/10.1016/j.ijrobp.2006.04.013
  37. Zhang GG, Ku L and Dilling TJ. (2011). Volumetric modulated arc planning for lung stereotactic body radiotherapy using conventional and unflattened photon beams: a dosimetric comparison with 3D technique. Radiat Oncol, 9, 152.
  38. Zimmermann FB, Geinitz H, Schill S, et al (2005). Stereotactic hypofractionated radiation therapy for stage I non-small cell lung cancer. Lung Cancer, 48, 107-14. https://doi.org/10.1016/j.lungcan.2004.10.015