TY - JOUR
T1 - Validation of active breathing control in patients with non-small-cell lung cancer to be treated with CHARTWEL
AU - Wilson, Elena M.
AU - Williams, F. Joy
AU - Lyn, B. Ethan
AU - Wong, John W.
AU - Aird, Edwin G.A.
N1 - Funding Information:
This work is supported in part by an NCI grant, R01 CA76182, and by Elekta Oncology Systems Ltd.
PY - 2003/11/1
Y1 - 2003/11/1
N2 - Purpose: Active breathing control (ABC) was validated using patients with non-small-cell lung cancer (NSCLC) to be treated with continuous hyperfractionated accelerated radiotherapy weekend-less (CHARTWEL). Effects of breath hold (BH) on accuracy and normal tissue doses were evaluated. Methods and Materials: Eleven patients were studied. Immediately after a free breathing (FB) planning scan, two ABC scans (ABC 1 and 2) were performed to assess intrafraction variation. A third ABC scan (ABC 3) was performed some weeks later to assess interfraction variation. Assisted BH was set at 75% of vital capacity and reproducibility assessed using computed tomography (CT) lung volumes. Planning target volumes (PTVs), doses to lung and spinal cord for FB and ABC 1 scans were compared. Results: Results were available for 10 patients. Disease and elective nodal regions were easier to define on ABC scans making PTVs smaller. ABC lung volumes showed no significant variation over several weeks, percentage volume of whole lung receiving ≥20 Gy (V20) was reduced in all (median 6.4%, p = 0.005), and spinal cord dose in 80% (median 1.03 Gy, p = 0.02), of the plans. Conclusions: ABC allowed reproducible BH, and enabled better delineation of tumor and normal structures, as well as reduction in PTV, V20, and spinal cord dose.
AB - Purpose: Active breathing control (ABC) was validated using patients with non-small-cell lung cancer (NSCLC) to be treated with continuous hyperfractionated accelerated radiotherapy weekend-less (CHARTWEL). Effects of breath hold (BH) on accuracy and normal tissue doses were evaluated. Methods and Materials: Eleven patients were studied. Immediately after a free breathing (FB) planning scan, two ABC scans (ABC 1 and 2) were performed to assess intrafraction variation. A third ABC scan (ABC 3) was performed some weeks later to assess interfraction variation. Assisted BH was set at 75% of vital capacity and reproducibility assessed using computed tomography (CT) lung volumes. Planning target volumes (PTVs), doses to lung and spinal cord for FB and ABC 1 scans were compared. Results: Results were available for 10 patients. Disease and elective nodal regions were easier to define on ABC scans making PTVs smaller. ABC lung volumes showed no significant variation over several weeks, percentage volume of whole lung receiving ≥20 Gy (V20) was reduced in all (median 6.4%, p = 0.005), and spinal cord dose in 80% (median 1.03 Gy, p = 0.02), of the plans. Conclusions: ABC allowed reproducible BH, and enabled better delineation of tumor and normal structures, as well as reduction in PTV, V20, and spinal cord dose.
KW - Active Breathing Control
KW - CHARTWEL
KW - Immobilization
KW - Non-small-cell lung cancer
KW - Respiratory movement
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U2 - 10.1016/S0360-3016(03)00712-0
DO - 10.1016/S0360-3016(03)00712-0
M3 - Article
C2 - 14529794
AN - SCOPUS:0141504127
SN - 0360-3016
VL - 57
SP - 864
EP - 874
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -