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Variations in target volume definition and dose to normal tissue using anatomic versus biological imaging (18F-FDG-PET) in the treatment of bone metastases : results from a 3-arm randomized phase II trial

Dieter Berwouts UGent, Katrien De Wolf, Wilfried De Neve UGent, ANA MARIA LUIZA OLTEANU, Bieke Lambert UGent, Bruno Speleers UGent, Ingeborg Goethals UGent, Indira Madani and Piet Ost UGent (2017) JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY. 61(1). p.124-132
abstract
Introduction: To report the impact on target volume delineation and dose to normal tissue using anatomic versus biological imaging (F-18-FDG-PET) for bone metastases. Methods: Patients with uncomplicated painful bone metastases were randomized (1:1:1) and blinded to receive either 8Gy in a single fraction with conventionally planned radiotherapy (ConvRT-8Gy) or 8Gy in a single fraction with dose-painting-by-numbers (DPBN) dose range between 6 and 10Gy) (DPBN-8Gy) or 16Gy in a single fraction with DPBN (dose range between 14 and 18Gy) (DPBN-16Gy). The primary endpoint was overall pain response at 1month. Volumes of the gross tumour volume (GTV) - both biological (GTV(PET)) and anatomical (GTV(CT)) -, planning target volume (PTV), dose to thenormal tissue and maximum standardized-uptake values (SUVMAX) were analysed (secondary endpoint). Results: Sixty-three percent of the GTV(CT) volume did not show F-18-FDG-uptake. On average, 20% of the GTV(PET) volume was outside GTV(CT). The volume of normal tissue receiving 4Gy, 6Gy and 8Gy was at least 3x, 6x and 13x smaller in DPBN-8Gy compared to ConvRT-8Gy and DPBN-16Gy (P<0.05). Conclusion: Positron emitting tomography-information potentially changes the target volume for bone metastases. DPBN between 6 and 10Gy significantly decreases dose to the normal tissue compared to conventional radiotherapy.
Please use this url to cite or link to this publication:
author
organization
alternative title
Variations in target volume definition and dose to normal tissue using anatomic versus biological imaging (F-18-FDG-PET) in the treatment of bone metastases : results from a 3-arm randomized phase II trial
year
type
journalArticle (original)
publication status
published
subject
keyword
bone metastasis, dose-painting-by-numbers, palliative treatment, stereotactic body radiotherapy, volume analysis, POSITRON-EMISSION-TOMOGRAPHY, CELL LUNG-CANCER, RADIATION-THERAPY, PALLIATIVE RADIOTHERAPY, SPINAL METASTASIS, STEREOTACTIC RADIOSURGERY, LOCAL-CONTROL, PAIN-CONTROL, CONSENSUS, SURVIVAL
journal title
JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY
J. Med. Imag. Radiat. Oncol.
volume
61
issue
1
pages
124 - 132
Web of Science type
Article
Web of Science id
000394960300015
ISSN
1754-9477
DOI
10.1111/1754-9485.12507
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
8505251
handle
http://hdl.handle.net/1854/LU-8505251
date created
2017-01-27 09:46:27
date last changed
2017-09-12 13:36:32
@article{8505251,
  abstract     = {Introduction: To report the impact on target volume delineation and dose to normal tissue using anatomic versus biological imaging (F-18-FDG-PET) for bone metastases. 
Methods: Patients with uncomplicated painful bone metastases were randomized (1:1:1) and blinded to receive either 8Gy in a single fraction with conventionally planned radiotherapy (ConvRT-8Gy) or 8Gy in a single fraction with dose-painting-by-numbers (DPBN) dose range between 6 and 10Gy) (DPBN-8Gy) or 16Gy in a single fraction with DPBN (dose range between 14 and 18Gy) (DPBN-16Gy). The primary endpoint was overall pain response at 1month. Volumes of the gross tumour volume (GTV) - both biological (GTV(PET)) and anatomical (GTV(CT)) -, planning target volume (PTV), dose to thenormal tissue and maximum standardized-uptake values (SUVMAX) were analysed (secondary endpoint). 
Results: Sixty-three percent of the GTV(CT) volume did not show F-18-FDG-uptake. On average, 20\% of the GTV(PET) volume was outside GTV(CT). The volume of normal tissue receiving 4Gy, 6Gy and 8Gy was at least 3x, 6x and 13x smaller in DPBN-8Gy compared to ConvRT-8Gy and DPBN-16Gy (P{\textlangle}0.05). 
Conclusion: Positron emitting tomography-information potentially changes the target volume for bone metastases. DPBN between 6 and 10Gy significantly decreases dose to the normal tissue compared to conventional radiotherapy.},
  author       = {Berwouts, Dieter and De Wolf, Katrien and De Neve, Wilfried and OLTEANU, ANA MARIA LUIZA and Lambert, Bieke and Speleers, Bruno and Goethals, Ingeborg and Madani, Indira and Ost, Piet},
  issn         = {1754-9477},
  journal      = {JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY},
  keyword      = {bone metastasis,dose-painting-by-numbers,palliative treatment,stereotactic body radiotherapy,volume analysis,POSITRON-EMISSION-TOMOGRAPHY,CELL LUNG-CANCER,RADIATION-THERAPY,PALLIATIVE RADIOTHERAPY,SPINAL METASTASIS,STEREOTACTIC RADIOSURGERY,LOCAL-CONTROL,PAIN-CONTROL,CONSENSUS,SURVIVAL},
  language     = {eng},
  number       = {1},
  pages        = {124--132},
  title        = {Variations in target volume definition and dose to normal tissue using anatomic versus biological imaging (18F-FDG-PET) in the treatment of bone metastases : results from a 3-arm randomized phase II trial},
  url          = {http://dx.doi.org/10.1111/1754-9485.12507},
  volume       = {61},
  year         = {2017},
}

Chicago
Berwouts, Dieter, Katrien De Wolf, Wilfried De Neve, ANA MARIA LUIZA OLTEANU, Bieke Lambert, Bruno Speleers, Ingeborg Goethals, Indira Madani, and Piet Ost. 2017. “Variations in Target Volume Definition and Dose to Normal Tissue Using Anatomic Versus Biological Imaging (18F-FDG-PET) in the Treatment of Bone Metastases : Results from a 3-arm Randomized Phase II Trial.” Journal of Medical Imaging and Radiation Oncology 61 (1): 124–132.
APA
Berwouts, D., De Wolf, K., De Neve, W., OLTEANU, A. M. L., Lambert, B., Speleers, B., Goethals, I., et al. (2017). Variations in target volume definition and dose to normal tissue using anatomic versus biological imaging (18F-FDG-PET) in the treatment of bone metastases : results from a 3-arm randomized phase II trial. JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, 61(1), 124–132.
Vancouver
1.
Berwouts D, De Wolf K, De Neve W, OLTEANU AML, Lambert B, Speleers B, et al. Variations in target volume definition and dose to normal tissue using anatomic versus biological imaging (18F-FDG-PET) in the treatment of bone metastases : results from a 3-arm randomized phase II trial. JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY. 2017;61(1):124–32.
MLA
Berwouts, Dieter, Katrien De Wolf, Wilfried De Neve, et al. “Variations in Target Volume Definition and Dose to Normal Tissue Using Anatomic Versus Biological Imaging (18F-FDG-PET) in the Treatment of Bone Metastases : Results from a 3-arm Randomized Phase II Trial.” JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY 61.1 (2017): 124–132. Print.