Dose as a Function of Lung Volume and Planned Treatment Volume in Helical Tomotherapy Intensity-Modulated Radiation Therapy-Based Stereotactic Body Radiation Therapy for Small Lung Tumors

Joseph M. Baisden, Davis A. Romney, Andrew G. Reish, Jing Cai, Ke Sheng, David R. Jones, Stanley H Benedict, Paul W. Read, James M. Larner

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Purpose: To evaluate the limitations of Hi-Art Helical Tomotherapy (Middleton, WI) stereotactic body radiotherapy (SBRT) for lung lesions, and to provide an initial report on patients treated with this method. Stereotactic body radiotherapy was shown to be an effective, well-tolerated treatment for early-stage, non-small-cell lung carcinoma (NSCLC). The Radiation Therapy Oncology Group (RTOG) 0236 protocol is currently evaluating three-dimensional conformal SBRT that delivers 60 Gy in three fractions. Methods and Materials: Inverse treatment planning for hypothetical lung gross tumor volumes (GTV) and planned treatment volume (PTV) expansions were performed. We tested the hypothesis that the maximum acceptable dose (MAD) to be delivered to the lesion by SBRT could be predicted by PTV and lung volume. Dose constraints on normal tissue were as designated by the RTOG protocol. Inverse planning was performed to find the maximum tolerated SBRT dose up to 60 Gy. Results: Regression analysis of the data obtained indicated a linear relationship between MAD, PTV, and lung volume. This generated two equations which may be useful predictive tools. Seven patients with Stage I and II NSCLC treated at the University of Virginia with this method tolerated the treatment extremely well, and suffered no greater than grade I toxicity, with no evidence of disease recurrence in follow-up from 2-20 months. Conclusions: Helical tomotherapy SBRT for lung lesions is well-tolerated. In addition, the likely MAD for patients considered for this type of treatment can be predicted by PTV and lung volume.

Original languageEnglish (US)
Pages (from-to)1229-1237
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume68
Issue number4
DOIs
StatePublished - Jul 15 2007
Externally publishedYes

Fingerprint

Intensity-Modulated Radiotherapy
lungs
Radiosurgery
radiation therapy
Radiotherapy
tumors
dosage
Lung
Neoplasms
lesions
Radiation Oncology
Therapeutics
Non-Small Cell Lung Carcinoma
planning
cancer
Conformal Radiotherapy
arts
Art
Tumor Burden
toxicity

Keywords

  • Lung
  • NSCLC
  • Radiosurgery
  • SBRT
  • Tomotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Dose as a Function of Lung Volume and Planned Treatment Volume in Helical Tomotherapy Intensity-Modulated Radiation Therapy-Based Stereotactic Body Radiation Therapy for Small Lung Tumors. / Baisden, Joseph M.; Romney, Davis A.; Reish, Andrew G.; Cai, Jing; Sheng, Ke; Jones, David R.; Benedict, Stanley H; Read, Paul W.; Larner, James M.

In: International Journal of Radiation Oncology Biology Physics, Vol. 68, No. 4, 15.07.2007, p. 1229-1237.

Research output: Contribution to journalArticle

Baisden, Joseph M. ; Romney, Davis A. ; Reish, Andrew G. ; Cai, Jing ; Sheng, Ke ; Jones, David R. ; Benedict, Stanley H ; Read, Paul W. ; Larner, James M. / Dose as a Function of Lung Volume and Planned Treatment Volume in Helical Tomotherapy Intensity-Modulated Radiation Therapy-Based Stereotactic Body Radiation Therapy for Small Lung Tumors. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 68, No. 4. pp. 1229-1237.
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abstract = "Purpose: To evaluate the limitations of Hi-Art Helical Tomotherapy (Middleton, WI) stereotactic body radiotherapy (SBRT) for lung lesions, and to provide an initial report on patients treated with this method. Stereotactic body radiotherapy was shown to be an effective, well-tolerated treatment for early-stage, non-small-cell lung carcinoma (NSCLC). The Radiation Therapy Oncology Group (RTOG) 0236 protocol is currently evaluating three-dimensional conformal SBRT that delivers 60 Gy in three fractions. Methods and Materials: Inverse treatment planning for hypothetical lung gross tumor volumes (GTV) and planned treatment volume (PTV) expansions were performed. We tested the hypothesis that the maximum acceptable dose (MAD) to be delivered to the lesion by SBRT could be predicted by PTV and lung volume. Dose constraints on normal tissue were as designated by the RTOG protocol. Inverse planning was performed to find the maximum tolerated SBRT dose up to 60 Gy. Results: Regression analysis of the data obtained indicated a linear relationship between MAD, PTV, and lung volume. This generated two equations which may be useful predictive tools. Seven patients with Stage I and II NSCLC treated at the University of Virginia with this method tolerated the treatment extremely well, and suffered no greater than grade I toxicity, with no evidence of disease recurrence in follow-up from 2-20 months. Conclusions: Helical tomotherapy SBRT for lung lesions is well-tolerated. In addition, the likely MAD for patients considered for this type of treatment can be predicted by PTV and lung volume.",
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AU - Romney, Davis A.

AU - Reish, Andrew G.

AU - Cai, Jing

AU - Sheng, Ke

AU - Jones, David R.

AU - Benedict, Stanley H

AU - Read, Paul W.

AU - Larner, James M.

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N2 - Purpose: To evaluate the limitations of Hi-Art Helical Tomotherapy (Middleton, WI) stereotactic body radiotherapy (SBRT) for lung lesions, and to provide an initial report on patients treated with this method. Stereotactic body radiotherapy was shown to be an effective, well-tolerated treatment for early-stage, non-small-cell lung carcinoma (NSCLC). The Radiation Therapy Oncology Group (RTOG) 0236 protocol is currently evaluating three-dimensional conformal SBRT that delivers 60 Gy in three fractions. Methods and Materials: Inverse treatment planning for hypothetical lung gross tumor volumes (GTV) and planned treatment volume (PTV) expansions were performed. We tested the hypothesis that the maximum acceptable dose (MAD) to be delivered to the lesion by SBRT could be predicted by PTV and lung volume. Dose constraints on normal tissue were as designated by the RTOG protocol. Inverse planning was performed to find the maximum tolerated SBRT dose up to 60 Gy. Results: Regression analysis of the data obtained indicated a linear relationship between MAD, PTV, and lung volume. This generated two equations which may be useful predictive tools. Seven patients with Stage I and II NSCLC treated at the University of Virginia with this method tolerated the treatment extremely well, and suffered no greater than grade I toxicity, with no evidence of disease recurrence in follow-up from 2-20 months. Conclusions: Helical tomotherapy SBRT for lung lesions is well-tolerated. In addition, the likely MAD for patients considered for this type of treatment can be predicted by PTV and lung volume.

AB - Purpose: To evaluate the limitations of Hi-Art Helical Tomotherapy (Middleton, WI) stereotactic body radiotherapy (SBRT) for lung lesions, and to provide an initial report on patients treated with this method. Stereotactic body radiotherapy was shown to be an effective, well-tolerated treatment for early-stage, non-small-cell lung carcinoma (NSCLC). The Radiation Therapy Oncology Group (RTOG) 0236 protocol is currently evaluating three-dimensional conformal SBRT that delivers 60 Gy in three fractions. Methods and Materials: Inverse treatment planning for hypothetical lung gross tumor volumes (GTV) and planned treatment volume (PTV) expansions were performed. We tested the hypothesis that the maximum acceptable dose (MAD) to be delivered to the lesion by SBRT could be predicted by PTV and lung volume. Dose constraints on normal tissue were as designated by the RTOG protocol. Inverse planning was performed to find the maximum tolerated SBRT dose up to 60 Gy. Results: Regression analysis of the data obtained indicated a linear relationship between MAD, PTV, and lung volume. This generated two equations which may be useful predictive tools. Seven patients with Stage I and II NSCLC treated at the University of Virginia with this method tolerated the treatment extremely well, and suffered no greater than grade I toxicity, with no evidence of disease recurrence in follow-up from 2-20 months. Conclusions: Helical tomotherapy SBRT for lung lesions is well-tolerated. In addition, the likely MAD for patients considered for this type of treatment can be predicted by PTV and lung volume.

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