Evaluation of lung tumor motion in a large sample: Target‐related and clinical factors influencing tumor motion based on four‐dimensional CT

• Published in: Cancer medicine (Malden, MA) MA), 2021-10, Vol.10 (20), p.7126-7135
• Main Authors: Li, Fengxiang, Qu, Yanlin, Zhang, Tingting, Cui, Zhen, Sun, Xin, Zhang, Tao, Li, Jianbin
• Format: Article
• Language: English
• Subjects: Aged; Body Mass Index; Body Surface Area; Cancer therapies; Clinical Cancer Researcher; clinical factors; Female; Four-Dimensional Computed Tomography; four‐dimensional CT; Humans; Lung - diagnostic imaging; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Lung Neoplasms - secondary; lung tumor; Male; Metastases; Metastasis; Middle Aged; Multivariate Analysis; Neoplasms, Multiple Primary - diagnostic imaging; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - radiotherapy; Organ Motion; Patients; Radiation therapy; Radiosurgery - methods; Respiration; Retrospective Studies; stereotactic body radiation therapy; Surgery; target‐related factors; Tumor Burden; tumor motion; Tumors; Variables
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.4255

Background and purpose We aimed to analyze the influence of target‐related and clinical factors on lung tumor motion based on four‐dimensional CT (4DCT), and clarify the motion based on subgroups in lung stereotactic body radiation therapy. Materials and methods 4DCT image data of 267 tumors from 246 patients were analyzed. The coordinates in the left–right (LR), anterior–posterior (AP), and cranial–caudal (CC) directions of the center of mass (COM) of the gross tumor volumes in 10 phases of 4DCT were measured. The peak‐to‐peak COM displacement in the LR, AP, CC, and 3D directions was calculated. The influence of target‐related and clinical factors on tumor motion was evaluated using multivariate analysis. Results The tumor segment location correlated with the tumor motion in each direction. Tumor size was predictive of tumor motion in the 3D (p = 0.023) and AP directions (p = 0.049). The tumor motion for metastatic tumors was smaller than that for primary tumors in the LR (p = 0.019) and AP directions (p = 0.008). The CC motion for pulmonary surgery recipients (3.8 ± 4.5 mm) was less than that for patients who had not undergone surgery (5.6 ± 5.4 mm), and no significant clinical factor was observed. BSA and BMI were positively correlated with the motion in the CC (p = 0.02) and LR directions (p = 0.002). Conclusion The tumor segment location was a good predictor of tumor motion. A larger tumor tends to have a smaller motion. Patients with metastatic tumors or those who have undergone pulmonary surgery exhibited smaller and more unpredictable tumor motions, which required individual assessments. Thus, clinical factors can potentially predict tumor motion. This study evaluated the tumor motion magnitude in different lung lobes and segments in a large sample. The purpose of the study was to systematically analyze the influence of the target‐related and clinical factors on tumor motion in different directions and to clarify the tumor motion magnitude for different subgroups of patients.