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Adaptive radiotherapy for locally advanced non-small cell lung cancer, can we predict when and for whom?

(2015) ACTA ONCOLOGICA. 54(9). p.1438-1444
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Abstract
Background. Adaptive radiotherapy (ART) could be a tool to reduce toxicity and to facilitate dose escalation in stage III NSCLC. Our aim was to identify the most appropriate time and potential benefit of ART. Material and methods. We analyzed volume reduction and dosimetric consequences of 41 patients who were treated with concurrent (cCRT) (n = 21) or sequential (sCRT) chemoradiotherapy to a median dose of 70 Gy, 2 Gy/F. At every treatment fraction a cone-beam CT (CBCT) was performed. The gross tumor volume (GTV-T) was adapted (exclusion of lymph nodes) to create the GTV-T-F1. Every fifth fraction (F5-F30), the GTV-T-F1 was adapted on the CBCT to create a GTV-T-Fx. Dose volume histograms were recalculated for every GTV-T-Fx, enabling to create lookup tables to predict the theoretical dosimetric advantage on common lung dose constraints. Results. The average GTV reduction was 42.1% (range 4.0-69.3%); 50.1% and 33.7% for the cCRT and sCRT patients, respectively. A linear relationship between GTV-T-F1 volume and absolute volume decrease was found for both groups. The mean V5, V20, V30 and mean lung dose increased by 0.8, 3.1, 5.2 and 3.4%, respectively. A larger increase (p < 0.05) was observed for peripheral tumors and cCRT. Lookup tables were generated. Conclusion. ART offers the most beneficial dosimetric effects when performed around fraction 15, especially for patients with a large initial GTV-T treated by cCRT.
Keywords
TRIAL, MOTION, REGRESSION, THERAPY, CONFORMAL RADIOTHERAPY, ACCELERATED RADIOTHERAPY, COMPUTED-TOMOGRAPHY

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Chicago
BERKOVIC, PATRICK, Leen Paelinck, Yolande Lievens, Akos Gulyban, Bruno Goddeeris, CRISTINA DERIE, Veerle Surmont, Wilfried De Neve, and Katrien Vandecasteele. 2015. “Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer, Can We Predict When and for Whom?” Acta Oncologica 54 (9): 1438–1444.
APA
BERKOVIC, P., Paelinck, L., Lievens, Y., Gulyban, A., Goddeeris, B., DERIE, C., Surmont, V., et al. (2015). Adaptive radiotherapy for locally advanced non-small cell lung cancer, can we predict when and for whom? ACTA ONCOLOGICA, 54(9), 1438–1444.
Vancouver
1.
BERKOVIC P, Paelinck L, Lievens Y, Gulyban A, Goddeeris B, DERIE C, et al. Adaptive radiotherapy for locally advanced non-small cell lung cancer, can we predict when and for whom? ACTA ONCOLOGICA. 2015;54(9):1438–44.
MLA
BERKOVIC, PATRICK, Leen Paelinck, Yolande Lievens, et al. “Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer, Can We Predict When and for Whom?” ACTA ONCOLOGICA 54.9 (2015): 1438–1444. Print.
@article{7058263,
  abstract     = {Background. Adaptive radiotherapy (ART) could be a tool to reduce toxicity and to facilitate dose escalation in stage III NSCLC. Our aim was to identify the most appropriate time and potential benefit of ART.
Material and methods. We analyzed volume reduction and dosimetric consequences of 41 patients who were treated with concurrent (cCRT) (n = 21) or sequential (sCRT) chemoradiotherapy to a median dose of 70 Gy, 2 Gy/F. At every treatment fraction a cone-beam CT (CBCT) was performed. The gross tumor volume (GTV-T) was adapted (exclusion of lymph nodes) to create the GTV-T-F1. Every fifth fraction (F5-F30), the GTV-T-F1 was adapted on the CBCT to create a GTV-T-Fx. Dose volume histograms were recalculated for every GTV-T-Fx, enabling to create lookup tables to predict the theoretical dosimetric advantage on common lung dose constraints.
Results. The average GTV reduction was 42.1\% (range 4.0-69.3\%); 50.1\% and 33.7\% for the cCRT and sCRT patients, respectively. A linear relationship between GTV-T-F1 volume and absolute volume decrease was found for both groups. The mean V5, V20, V30 and mean lung dose increased by 0.8, 3.1, 5.2 and 3.4\%, respectively. A larger increase (p {\textlangle} 0.05) was observed for peripheral tumors and cCRT. Lookup tables were generated.
Conclusion. ART offers the most beneficial dosimetric effects when performed around fraction 15, especially for patients with a large initial GTV-T treated by cCRT.},
  author       = {BERKOVIC, PATRICK and Paelinck, Leen and Lievens, Yolande and Gulyban, Akos and Goddeeris, Bruno and DERIE, CRISTINA and Surmont, Veerle and De Neve, Wilfried and Vandecasteele, Katrien},
  issn         = {0284-186X},
  journal      = {ACTA ONCOLOGICA},
  keyword      = {TRIAL,MOTION,REGRESSION,THERAPY,CONFORMAL RADIOTHERAPY,ACCELERATED RADIOTHERAPY,COMPUTED-TOMOGRAPHY},
  language     = {eng},
  number       = {9},
  pages        = {1438--1444},
  title        = {Adaptive radiotherapy for locally advanced non-small cell lung cancer, can we predict when and for whom?},
  url          = {http://dx.doi.org/10.3109/0284186X.2015.1061209},
  volume       = {54},
  year         = {2015},
}

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