Dose escalation in the radiotherapy of non-small-cell lung cancer with aperture-based intensity modulation and photon beam energy optimization for non-preselected patients

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Jason St-HilaireLuc Beaulieu

Abstract

To verify the potential of aperture-based intensity-modulated radiotherapy (AB-IMRT) to realize dose escalation plans for non-preselected non-small-cell lung cancer (NSCLC) patients, using photon beam energy optimization. Seven cases of NSCLC were retrospectively studied. Clinical reference plans were made at 60 Gy by an experienced dosimetrist. Dose escalation was applied to PTV2, a subvolume within the main PTV1. Escalation plans were optimized by considering beam angles (table and gantry), energy (6 and 23 MV) and weights, for an increasing dose to the PTV2, starting from 66 Gy and keeping 30 fractions. In five cases, doses over 78 Gy could be achieved before exceeding organs at risk (OARs) standard tolerance. Peripheral overdosages, as well as lung and spinal cord tolerance doses, limited escalation. Means+/-SD V(95%) parameters were (97.3+/-0.9)% for PTV1s and (96.7+/-2.2)% for PTV2s. Doses to OARs were also maintained at acceptable levels. Optimized plans made use of both low- and high-energy beams and had a similar number of monitor units compared to the 60 Gy clinical plans. The AB-IMRT system can successfully realize dose escalation for a sizeable number of cases. Plans produced contained few large segments, and are ap...Continue Reading

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Citations

Feb 23, 2010·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·David I Thwaites, Dirk Verellen
May 26, 2009·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Michael BaumannSteffen Appold
Mar 16, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Wouter van ElmptFrank Verhaegen
Oct 4, 2011·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Jason St-HilaireDaniel Tremblay
Nov 22, 2011·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Anna SimeonovaFrank Lohr

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