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

PATRICK BERKOVIC, Leen Paelinck, Yolande Lievens UGent, Akos Gulyban, Bruno Goddeeris, CRISTINA DERIE, Veerle Surmont UGent, Wilfried De Neve UGent and Katrien Vandecasteele UGent (2015) ACTA ONCOLOGICA. 54(9). p.1438-1444
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
TRIAL, MOTION, REGRESSION, THERAPY, CONFORMAL RADIOTHERAPY, ACCELERATED RADIOTHERAPY, COMPUTED-TOMOGRAPHY
journal title
ACTA ONCOLOGICA
Acta Oncol.
volume
54
issue
9
pages
1438 - 1444
Web of Science type
Article
Web of Science id
000366674700028
JCR category
ONCOLOGY
JCR impact factor
3.73 (2015)
JCR rank
66/213 (2015)
JCR quartile
2 (2015)
ISSN
0284-186X
DOI
10.3109/0284186X.2015.1061209
language
English
UGent publication?
yes
classification
A1
additional info
the first two authors contributed equally to this work
copyright statement
I have transferred the copyright for this publication to the publisher
id
7058263
handle
http://hdl.handle.net/1854/LU-7058263
date created
2016-01-28 08:31:36
date last changed
2018-03-21 14:56:33
@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},
}

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.