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AP-PA field orientation followed by IMRT reduces lung exposure in comparison to conventional 3D conformal and sole IMRT in centrally located lung tumors.

Soyfer V, Meir Y, Corn BW, Schifter D, Gez E, Tempelhoff H, Shtraus N - Radiat Oncol (2012)

Bottom Line: Little attention has been paid to the fact that intensity modulated radiation therapy (IMRT) techniques do not easily enable treatment with opposed beams.Three treatment plans (3 D conformal, IMRT, and combined (anterior-posterior-posterio-anterior (AP-PA) + IMRT) of 7 patients with centrally-located lung cancer were compared for exposure of lung, spinal cord and esophagus.Combined IMRT and AP-PA techniques offer better lung tissue sparing compared to plans predicated solely on IMRT for centrally-located lung tumors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Tel Aviv Sourasky Medical Center, Radiation Oncology Department, Tel Aviv, Israel. slavas2506@yahoo.com

ABSTRACT
Little attention has been paid to the fact that intensity modulated radiation therapy (IMRT) techniques do not easily enable treatment with opposed beams. Three treatment plans (3 D conformal, IMRT, and combined (anterior-posterior-posterio-anterior (AP-PA) + IMRT) of 7 patients with centrally-located lung cancer were compared for exposure of lung, spinal cord and esophagus. Combined IMRT and AP-PA techniques offer better lung tissue sparing compared to plans predicated solely on IMRT for centrally-located lung tumors.

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Related in: MedlinePlus

Volumetric exposure of the total lung - GTV. The figure depicts the comparative percentage of the total lung - GTV volume exposure related to the dose of radiation of 5 Gy, 10 Gy, 20 Gy and 30 Gy for three different techniques of the treatment (3D, IMRT and combined IMRT + AP-PA) grouped together for each dose superlatively
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Figure 4: Volumetric exposure of the total lung - GTV. The figure depicts the comparative percentage of the total lung - GTV volume exposure related to the dose of radiation of 5 Gy, 10 Gy, 20 Gy and 30 Gy for three different techniques of the treatment (3D, IMRT and combined IMRT + AP-PA) grouped together for each dose superlatively

Mentions: The PTV dose coverage with heterogeneity correction was equivalent in all three plans: 95.3 ± 4.9% (STDV), 95.5 ± 5.6%, 94.6 ± 2.3% in 3D, IMRT and combined (IMRT and AP-PA) plans relatively (Figure 1). The DVH of the lung in three comparative plans for 3D, IMRT and combined plans for the total lung -GTV was as follow: V5- 63.2 ± 8.6%, 63.9 ± 9.2%, 56.6 ± 11.4%; V10- 53.07 ± 10.1%, 52.3 ± 11.2%, 38.8 ± 9.6%; V20- 27.6 ± 6.7%, 31.1 ± 7.0%, 20.6 ± 2.3%; V30- 14.3 ± 4.6%, 13.36 ± 0.37%, 14.96 ± 1.22% and V40- 8.05 ± 4.62, 5.76 ± 2.15 and9.21 ± 1.62 respectively (Figure 2, 3). The mean dose to the right lung- GTV was 17.27 ± 5.47 Gy, 16.17 ± 4.59 Gy, 13.51 ± 5.42 Gy, respectively. The mean dose to the left lung - GTV was 12.1 ± 5.53 Gy, 13.27 ± 4.02 Gy, 9.31 ± 5.77 Gy. The maximal dose to the esophagus was 53.21 ± 3.05, 54.4 ± 4.67, 52.3 ± 4.5 Gy, respectively. Maximal dose to the spinal cord was 42.5 ± 2.9, 39.58 ± 1.2 and 43.7 ± 4.5 Gy respectively. DVHs and axial plans of the representative techniques are presented in Figure 3, 4


AP-PA field orientation followed by IMRT reduces lung exposure in comparison to conventional 3D conformal and sole IMRT in centrally located lung tumors.

Soyfer V, Meir Y, Corn BW, Schifter D, Gez E, Tempelhoff H, Shtraus N - Radiat Oncol (2012)

Volumetric exposure of the total lung - GTV. The figure depicts the comparative percentage of the total lung - GTV volume exposure related to the dose of radiation of 5 Gy, 10 Gy, 20 Gy and 30 Gy for three different techniques of the treatment (3D, IMRT and combined IMRT + AP-PA) grouped together for each dose superlatively
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3298785&req=5

Figure 4: Volumetric exposure of the total lung - GTV. The figure depicts the comparative percentage of the total lung - GTV volume exposure related to the dose of radiation of 5 Gy, 10 Gy, 20 Gy and 30 Gy for three different techniques of the treatment (3D, IMRT and combined IMRT + AP-PA) grouped together for each dose superlatively
Mentions: The PTV dose coverage with heterogeneity correction was equivalent in all three plans: 95.3 ± 4.9% (STDV), 95.5 ± 5.6%, 94.6 ± 2.3% in 3D, IMRT and combined (IMRT and AP-PA) plans relatively (Figure 1). The DVH of the lung in three comparative plans for 3D, IMRT and combined plans for the total lung -GTV was as follow: V5- 63.2 ± 8.6%, 63.9 ± 9.2%, 56.6 ± 11.4%; V10- 53.07 ± 10.1%, 52.3 ± 11.2%, 38.8 ± 9.6%; V20- 27.6 ± 6.7%, 31.1 ± 7.0%, 20.6 ± 2.3%; V30- 14.3 ± 4.6%, 13.36 ± 0.37%, 14.96 ± 1.22% and V40- 8.05 ± 4.62, 5.76 ± 2.15 and9.21 ± 1.62 respectively (Figure 2, 3). The mean dose to the right lung- GTV was 17.27 ± 5.47 Gy, 16.17 ± 4.59 Gy, 13.51 ± 5.42 Gy, respectively. The mean dose to the left lung - GTV was 12.1 ± 5.53 Gy, 13.27 ± 4.02 Gy, 9.31 ± 5.77 Gy. The maximal dose to the esophagus was 53.21 ± 3.05, 54.4 ± 4.67, 52.3 ± 4.5 Gy, respectively. Maximal dose to the spinal cord was 42.5 ± 2.9, 39.58 ± 1.2 and 43.7 ± 4.5 Gy respectively. DVHs and axial plans of the representative techniques are presented in Figure 3, 4

Bottom Line: Little attention has been paid to the fact that intensity modulated radiation therapy (IMRT) techniques do not easily enable treatment with opposed beams.Three treatment plans (3 D conformal, IMRT, and combined (anterior-posterior-posterio-anterior (AP-PA) + IMRT) of 7 patients with centrally-located lung cancer were compared for exposure of lung, spinal cord and esophagus.Combined IMRT and AP-PA techniques offer better lung tissue sparing compared to plans predicated solely on IMRT for centrally-located lung tumors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Tel Aviv Sourasky Medical Center, Radiation Oncology Department, Tel Aviv, Israel. slavas2506@yahoo.com

ABSTRACT
Little attention has been paid to the fact that intensity modulated radiation therapy (IMRT) techniques do not easily enable treatment with opposed beams. Three treatment plans (3 D conformal, IMRT, and combined (anterior-posterior-posterio-anterior (AP-PA) + IMRT) of 7 patients with centrally-located lung cancer were compared for exposure of lung, spinal cord and esophagus. Combined IMRT and AP-PA techniques offer better lung tissue sparing compared to plans predicated solely on IMRT for centrally-located lung tumors.

Show MeSH
Related in: MedlinePlus