Sci-Fri PM: Planning-04: Dose escalation study using anatomy-based aperture IMRT and SPECT perfusion images for lung cancer.

Abstract:

:In the case of non-small cell lung cancer, doses typically prescribed (60-66 Gy) are not sufficient to ensure a satisfactory tumor control probability. Dose escalation needs to be realized, but dose to organs at risk (OARs) must be kept under widely accepted clinical thresholds. Also, lung functionality is not homogeneously distributed over all the volume: single-photon emission computed tomography (SPECT) allows spatial characterization of perfusion, open the way to the design of treatments plans that could preferentially avoid highly-functional lung. In this study, three cases of lung cancer were retrospectively used to assess the capacity of an anatomy-based aperture inverse planning system to realize dose escalation while limiting dose to perfused lung. Plans were generated for four-beam non-coplanar configurations, mixing 6 and 23 MV photon beams. All dose calculations were performed using Pinnacle3 superposition/convolution algorithm. An increasing dose was prescribed to a subvolume of the initial planning target volume. Levels of escalation achieved for the three cases studied were 81 Gy, 111 Gy and 66 Gy to the subvolume. Escalation was limited in two cases by the dose to the esophagus and in the other case by the presence of overdosages near beam entry ports. Calculation of dose-volume parameters for OARs shows that they respect clinical thresholds. Plans generated by the system are less complex than plans generated in beamlet-based IMRT, because of the use of few, large segments. The approach used in this study allows important dose escalation, potentially improving treatment outcome.

journal_name

Med Phys

journal_title

Medical physics

authors

St-Hilaire J,Lavoie C,Beaulieu F,Dagnault A,Morin F,Gingras L,Tremblay D,Beaulieu L

doi

10.1118/1.2965976

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

3412-3413

issue

7Part3

eissn

0094-2405

issn

2473-4209

journal_volume

35

pub_type

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