Author ORCID Identifier
https://orcid.org/0000-0002-9763-5867
https://orcid.org/0000-0002-2224-9478
N/A
N/A
https://orcid.org/0000-0002-3255-6412
N/A
Document Type
Article
Publication Date
2013
College/Unit
School of Medicine
Department/Program/Center
Radiation Oncology
Abstract
Background
No selection criteria for helical tomotherapy (HT) based stereotactic ablative radiotherapy (SABR) to treat early stage non-small cell lung cancer (NSCLC) or solitary lung metastases has been established. In this study, we investigate the dosimetric selection criteria for HT based SABR delivering 70 Gy in 10 fractions to avoid severe toxicity in the treatment of centrally located lesions when adequate target dose coverage is desired.
Materials and Methods
78 HT-SABR plans for solitary lung lesions were created to prescribe 70 Gy in 10 fractions to the planning target volume (PTV). The PTV was set to have ≥95% PTV receiving 70 Gy in each case. The cases for which dose constraints for ≥1 OAR could not be met without compromising the target dose coverage were compared with cases for which all target and OAR dose constraints were met.
Results
There were 23 central lesions for which OAR dose constraints could not be met without compromising PTV dose coverage. Comparing to cases for which optimal HT-based SABR plans were generated, they were associated with larger tumor size (5.72±1.96 cm vs. 3.74±1.49 cm, p<0.0001), higher lung dose, increased number of immediately adjacent OARs ( 3.45±1.34 vs. 1.66±0.81, p<0.0001), and shorter distance to the closest OARs (GTV: 0.26±0.22 cm vs. 0.88±0.54 cm, p<0.0001; PTV 0.19±0.18 cm vs. 0.48±0.36 cm, p = 0.0001).
Conclusion
Delivery of 70 Gy in 10 fractions with HT to meet all the given OAR and PTV dose constraints are most likely when the following parameters are met: lung lesions ≤3.78 cm (11.98 cc), ≤2 immediately adjacent OARs which are ≥0.45 cm from the gross lesion and ≥0.21 cm from the PTV.
Digital Commons Citation
Chi, Alexander; Liao, Zhongxing; Nguyen, Nam P.; Xu, Jiahong; Welsh, James S.; Jang, Si Y.; Howe, Carol; and Komaki, Ritsuko, "Dosimetric Selection for Helical Tomotherapy Based Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer or Lung Metastases" (2013). Faculty & Staff Scholarship. 2734.
https://researchrepository.wvu.edu/faculty_publications/2734
Source Citation
Chi A, Liao Z, Nguyen NP, Xu J, Welsh JS, Jang SY, et al. (2012) Dosimetric Selection for Helical Tomotherapy Based Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer or Lung Metastases. PLoS ONE 7(4): e35809. https://doi.org/10.1371/journal.pone.0035809
Comments
© 2012 Chi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.