open access

Vol 13, No 5 (2008)
Untitled
Published online: 2008-09-01
Submitted: 2008-04-22
Get Citation

Does the IMRT technique allow improvement of treatment plans (e.g. lung sparing) for lung cancer patients with small lung volume: a planning study

Katarzyna KOMOSIŃSKA, Marta GIŻYŃSKA, Anna ZAWADZKA, Lucyna KĘPKA
DOI: 10.1016/S1507-1367(10)60091-0
·
Rep Pract Oncol Radiother 2008;13(5):220-226.

open access

Vol 13, No 5 (2008)
Untitled
Published online: 2008-09-01
Submitted: 2008-04-22

Abstract

Aim

We evaluated whether intensity-modulated radiation therapy (IMRT) may offer any advantages in comparison with three-dimensional conformal radiotherapy (3D-CRT) for patients with small lung volume (SLV).

Methods

Treatment planning was performed for 10 NSCLC patients with the smallest lung volume (mean: 2241 cc) among 200 patients from our database. For each patient 3D-CRT and IMRT plans were prepared. The goal was to deliver 66 Gy/33 fractions, with dose constraints: mean lung dose (MLD) <20Gy, V20<35%; spinal cord – Dmax<45 Gy. When the plan could not meet these criteria, total dose was reduced. The 3D-CRT and IMRT plans were compared. We investigated: prescribed dose, coverage and conformity indices, MLD, V5-V65 in the lung.

Results

In 4 out of 10 plans, 3D-CRT did not allow 66 Gy to be delivered, because of predicted pulmonary toxicity. These 4 cases included 3 for which we did not reach 66 Gy with IMRT; still, for these 3 plans the total dose was increased by an average of 9 Gy with IMRT in comparison with 3D-CRT. Coverage indices were similar for both techniques. Conformity indices were better for IMRT plans. MLD was lower in five IMRT and two 3D-CRT plans if equal doses were delivered. The decrease in MLD was seen for cases with large PTV and high PTV/lung volume ratio. Lung V5 was lower for all 3D-CRT plans, 47% vs. 57% for IMRT; V15 and above were larger for 3D-CRT

Conclusion

In the planning study, IMRT seems to be a promising technique for cases with SLV, especially when associated with large PTV.

Abstract

Aim

We evaluated whether intensity-modulated radiation therapy (IMRT) may offer any advantages in comparison with three-dimensional conformal radiotherapy (3D-CRT) for patients with small lung volume (SLV).

Methods

Treatment planning was performed for 10 NSCLC patients with the smallest lung volume (mean: 2241 cc) among 200 patients from our database. For each patient 3D-CRT and IMRT plans were prepared. The goal was to deliver 66 Gy/33 fractions, with dose constraints: mean lung dose (MLD) <20Gy, V20<35%; spinal cord – Dmax<45 Gy. When the plan could not meet these criteria, total dose was reduced. The 3D-CRT and IMRT plans were compared. We investigated: prescribed dose, coverage and conformity indices, MLD, V5-V65 in the lung.

Results

In 4 out of 10 plans, 3D-CRT did not allow 66 Gy to be delivered, because of predicted pulmonary toxicity. These 4 cases included 3 for which we did not reach 66 Gy with IMRT; still, for these 3 plans the total dose was increased by an average of 9 Gy with IMRT in comparison with 3D-CRT. Coverage indices were similar for both techniques. Conformity indices were better for IMRT plans. MLD was lower in five IMRT and two 3D-CRT plans if equal doses were delivered. The decrease in MLD was seen for cases with large PTV and high PTV/lung volume ratio. Lung V5 was lower for all 3D-CRT plans, 47% vs. 57% for IMRT; V15 and above were larger for 3D-CRT

Conclusion

In the planning study, IMRT seems to be a promising technique for cases with SLV, especially when associated with large PTV.

Get Citation

Keywords

IMRT; lung cancer; radiotherapy; lung volume; planning study

About this article
Title

Does the IMRT technique allow improvement of treatment plans (e.g. lung sparing) for lung cancer patients with small lung volume: a planning study

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 13, No 5 (2008)

Pages

220-226

Published online

2008-09-01

DOI

10.1016/S1507-1367(10)60091-0

Bibliographic record

Rep Pract Oncol Radiother 2008;13(5):220-226.

Keywords

IMRT
lung cancer
radiotherapy
lung volume
planning study

Authors

Katarzyna KOMOSIŃSKA
Marta GIŻYŃSKA
Anna ZAWADZKA
Lucyna KĘPKA

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl