open access

Vol 25, No 1 (2020)
Published online: 2020-01-01
Submitted: 2019-06-28
Get Citation

The importance of image guided radiotherapy in small cell lung cancer: Case report and review of literature

Francisco Javier Lozano Ruiz, Sandra Ileana Pérez Álvarez, María Adela Poitevin Chacón, Federico Maldonado Magos, Rubi Ramos Prudencio, Luis Cabrera Miranda, Oscar Arrieta
DOI: 10.1016/j.rpor.2019.12.013
·
Rep Pract Oncol Radiother 2020;25(1):146-149.

open access

Vol 25, No 1 (2020)
Published online: 2020-01-01
Submitted: 2019-06-28

Abstract

Aim

Describe the anatomical changes and tumor displacement due to a rapid response of a patient’s small cell lung cancer (SCLC) during definitive chemoradiotherapy (CRT).

Background

The treatment for SCLC is based on CRT. If interfractional changes during RT are incorrectly assessed they might compromise adequate coverage of the tumor or increase dose to organs at risk. Image guided RT with cone-beam computed tomography (CBCT) allows to identify daily treatment variations.

Material and methods

Describe a SCLC case with rapid changes in size, shape and location of the primary tumor during RT.

Case report

A 62-year-old woman was diagnosed with SCLC with complete obstruction of the anterior and lingular bronchi and incomplete left thorax expansion due to a 12×15cm mass. During CRT (45Gy in 1.5Gy per fraction, twice daily) the patient presented rapid tumor response, leading to resolution of bronchi obstruction and hemithorax expansion. Tumor shifted up to 4cm from its original position. The identification of variations led to two new simulations and planning in a 3-week treatment course.

Conclusions

The complete radiological response was possible due to systematic monitoring of the tumor during CRT. We recommend frequent on-site image verification. Daily CBCT should be considered with pretreatment tumor obstruction, pleural effusion, atelectasis, large volumes or radiosensitive histology that might resolve early and rapidly and could lead to a miss of the tumor or increased toxicity. Further research should be made in replanning effect in coverage of microscopic disease since it increases uncertainty in this scenario.

Abstract

Aim

Describe the anatomical changes and tumor displacement due to a rapid response of a patient’s small cell lung cancer (SCLC) during definitive chemoradiotherapy (CRT).

Background

The treatment for SCLC is based on CRT. If interfractional changes during RT are incorrectly assessed they might compromise adequate coverage of the tumor or increase dose to organs at risk. Image guided RT with cone-beam computed tomography (CBCT) allows to identify daily treatment variations.

Material and methods

Describe a SCLC case with rapid changes in size, shape and location of the primary tumor during RT.

Case report

A 62-year-old woman was diagnosed with SCLC with complete obstruction of the anterior and lingular bronchi and incomplete left thorax expansion due to a 12×15cm mass. During CRT (45Gy in 1.5Gy per fraction, twice daily) the patient presented rapid tumor response, leading to resolution of bronchi obstruction and hemithorax expansion. Tumor shifted up to 4cm from its original position. The identification of variations led to two new simulations and planning in a 3-week treatment course.

Conclusions

The complete radiological response was possible due to systematic monitoring of the tumor during CRT. We recommend frequent on-site image verification. Daily CBCT should be considered with pretreatment tumor obstruction, pleural effusion, atelectasis, large volumes or radiosensitive histology that might resolve early and rapidly and could lead to a miss of the tumor or increased toxicity. Further research should be made in replanning effect in coverage of microscopic disease since it increases uncertainty in this scenario.

Get Citation

Keywords

Radiotherapy; Image guided; Small cell lung cancer; Adaptive radiotherapy

About this article
Title

The importance of image guided radiotherapy in small cell lung cancer: Case report and review of literature

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 1 (2020)

Pages

146-149

Published online

2020-01-01

DOI

10.1016/j.rpor.2019.12.013

Bibliographic record

Rep Pract Oncol Radiother 2020;25(1):146-149.

Keywords

Radiotherapy
Image guided
Small cell lung cancer
Adaptive radiotherapy

Authors

Francisco Javier Lozano Ruiz
Sandra Ileana Pérez Álvarez
María Adela Poitevin Chacón
Federico Maldonado Magos
Rubi Ramos Prudencio
Luis Cabrera Miranda
Oscar Arrieta

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