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Stereotactic body radiotherapy for small lung tumors in the University of Tokyo Hospital.

Yamashita H, Takahashi W, Haga A, Kida S, Saotome N, Nakagawa K - Biomed Res Int (2014)

Bottom Line: Our work on stereotactic body radiation therapy (SBRT) for primary and metastatic lung tumors will be described.The eligibility criteria for SBRT, our previous SBRT method, the definition of target volume, heterogeneity correction, the position adjustment using four-dimensional cone-beam computed tomography (4D CBCT) immediately before SBRT, volumetric modulated arc therapy (VMAT) method for SBRT, verifying of tumor position within internal target volume (ITV) using in-treatment 4D-CBCT during VMAT-SBRT, shortening of treatment time using flattening-filter-free (FFF) techniques, delivery of 4D dose calculation for lung-VMAT patients using in-treatment CBCT and LINAC log data with agility multileaf collimator, and SBRT method for centrally located lung tumors in our institution will be shown.In our institution, these efforts have been made with the goal of raising the local control rate and decreasing adverse effects after SBRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

ABSTRACT
Our work on stereotactic body radiation therapy (SBRT) for primary and metastatic lung tumors will be described. The eligibility criteria for SBRT, our previous SBRT method, the definition of target volume, heterogeneity correction, the position adjustment using four-dimensional cone-beam computed tomography (4D CBCT) immediately before SBRT, volumetric modulated arc therapy (VMAT) method for SBRT, verifying of tumor position within internal target volume (ITV) using in-treatment 4D-CBCT during VMAT-SBRT, shortening of treatment time using flattening-filter-free (FFF) techniques, delivery of 4D dose calculation for lung-VMAT patients using in-treatment CBCT and LINAC log data with agility multileaf collimator, and SBRT method for centrally located lung tumors in our institution will be shown. In our institution, these efforts have been made with the goal of raising the local control rate and decreasing adverse effects after SBRT.

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CT images showing dose distributions of the patients with top five cases of the minimum doses in the most irradiated 2 cc of the mediastinal structures (D2cc). Cyan, internal target volume (ITV); pink, planning target volume (PTV).
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fig11: CT images showing dose distributions of the patients with top five cases of the minimum doses in the most irradiated 2 cc of the mediastinal structures (D2cc). Cyan, internal target volume (ITV); pink, planning target volume (PTV).

Mentions: A centrally located tumor was defined as being within 2 cm of the bronchial tree, major vessels, esophagus, heart, trachea, pericardium, brachial plexus, or vertebral body. The planned dose at the PTV95% was 56 Gy in seven fractions (BED10 = 100.8 Gy) (Figure 11). Our retrospective study [73] demonstrated that SBRT for 45 centrally located lung tumors resulted in excellent local tumor control. The 2-year LCR of 77.3% compared favorably with other rates reported in the literature. As for the 2-year OS, there was a significant difference between primary NSCLC (n = 32) and pulmonary metastasis (n = 13) (69.4% versus 46.9%, P = 0.04) after the median follow-up time of 21.2 months. Since new metastases occur frequently in patients with lung metastases, they might carry a poor prognosis after successful delivery of the first SBRT.


Stereotactic body radiotherapy for small lung tumors in the University of Tokyo Hospital.

Yamashita H, Takahashi W, Haga A, Kida S, Saotome N, Nakagawa K - Biomed Res Int (2014)

CT images showing dose distributions of the patients with top five cases of the minimum doses in the most irradiated 2 cc of the mediastinal structures (D2cc). Cyan, internal target volume (ITV); pink, planning target volume (PTV).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109604&req=5

fig11: CT images showing dose distributions of the patients with top five cases of the minimum doses in the most irradiated 2 cc of the mediastinal structures (D2cc). Cyan, internal target volume (ITV); pink, planning target volume (PTV).
Mentions: A centrally located tumor was defined as being within 2 cm of the bronchial tree, major vessels, esophagus, heart, trachea, pericardium, brachial plexus, or vertebral body. The planned dose at the PTV95% was 56 Gy in seven fractions (BED10 = 100.8 Gy) (Figure 11). Our retrospective study [73] demonstrated that SBRT for 45 centrally located lung tumors resulted in excellent local tumor control. The 2-year LCR of 77.3% compared favorably with other rates reported in the literature. As for the 2-year OS, there was a significant difference between primary NSCLC (n = 32) and pulmonary metastasis (n = 13) (69.4% versus 46.9%, P = 0.04) after the median follow-up time of 21.2 months. Since new metastases occur frequently in patients with lung metastases, they might carry a poor prognosis after successful delivery of the first SBRT.

Bottom Line: Our work on stereotactic body radiation therapy (SBRT) for primary and metastatic lung tumors will be described.The eligibility criteria for SBRT, our previous SBRT method, the definition of target volume, heterogeneity correction, the position adjustment using four-dimensional cone-beam computed tomography (4D CBCT) immediately before SBRT, volumetric modulated arc therapy (VMAT) method for SBRT, verifying of tumor position within internal target volume (ITV) using in-treatment 4D-CBCT during VMAT-SBRT, shortening of treatment time using flattening-filter-free (FFF) techniques, delivery of 4D dose calculation for lung-VMAT patients using in-treatment CBCT and LINAC log data with agility multileaf collimator, and SBRT method for centrally located lung tumors in our institution will be shown.In our institution, these efforts have been made with the goal of raising the local control rate and decreasing adverse effects after SBRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

ABSTRACT
Our work on stereotactic body radiation therapy (SBRT) for primary and metastatic lung tumors will be described. The eligibility criteria for SBRT, our previous SBRT method, the definition of target volume, heterogeneity correction, the position adjustment using four-dimensional cone-beam computed tomography (4D CBCT) immediately before SBRT, volumetric modulated arc therapy (VMAT) method for SBRT, verifying of tumor position within internal target volume (ITV) using in-treatment 4D-CBCT during VMAT-SBRT, shortening of treatment time using flattening-filter-free (FFF) techniques, delivery of 4D dose calculation for lung-VMAT patients using in-treatment CBCT and LINAC log data with agility multileaf collimator, and SBRT method for centrally located lung tumors in our institution will be shown. In our institution, these efforts have been made with the goal of raising the local control rate and decreasing adverse effects after SBRT.

Show MeSH
Related in: MedlinePlus