SU‐E‐T‐875: The Potential for Respiratory‐Gated VMAT to Reduce the Normal Lung Dose When Treating Early‐Stage Lung Cancer with SBRT

Purpose: To evaluate the dosimetric potential of respiratory‐gated volumetric‐modulated arc therapy (VMAT) to reduce the dose to normal lung when treating early stage non‐small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT). Methods: Seven early‐stage NSCLC patients were re...

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Published in:Medical Physics 2011-06, Vol.38 (6), p.3693-3693
Main Authors: Xhaferllari, I, Hamelin, N, Chen, J, Gaede, S
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Language:English
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Cancer
Dosimetry
Lungs
Radiation therapy
Radiation treatment
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Hamelin, N
Chen, J
Gaede, S
description Purpose: To evaluate the dosimetric potential of respiratory‐gated volumetric‐modulated arc therapy (VMAT) to reduce the dose to normal lung when treating early stage non‐small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT). Methods: Seven early‐stage NSCLC patients were retrospectively planned with gated and un‐gated VMAT using Smart Arc (Pinnacle v9.0, Philips Medical Systems, Cleveland, USA). The average 4D‐CT of each patient was used as the planning CT for the un‐gated VMAT plans. A subset average CT that minimized the motion within a 30% gating window was used as the planning CT for the gated VMAT plans. Each VMAT plan consisted of one arc to minimize the delivery time. All plans were prescribed 54 Gy in 3 fractions and all dosimetric parameters satisfied the requirements of our in‐house lung SBRT protocol. In order to avoid dosimetry bias between the gated and un‐gated plans, a Pinnacle host script was generated and used to optimize all 14 plans. Dosimetric parameters such as D(2cm), V(20), and the total normal lung volume receiving 50% of the prescription dose were compared. Results: There was a significant decrease in all dosimetric parameters considered in this study. D(2cm) decreased from (53.960 +/− 2.680)% to (51.703 +/− 1.907)% (p
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Methods: Seven early‐stage NSCLC patients were retrospectively planned with gated and un‐gated VMAT using Smart Arc (Pinnacle v9.0, Philips Medical Systems, Cleveland, USA). The average 4D‐CT of each patient was used as the planning CT for the un‐gated VMAT plans. A subset average CT that minimized the motion within a 30% gating window was used as the planning CT for the gated VMAT plans. Each VMAT plan consisted of one arc to minimize the delivery time. All plans were prescribed 54 Gy in 3 fractions and all dosimetric parameters satisfied the requirements of our in‐house lung SBRT protocol. In order to avoid dosimetry bias between the gated and un‐gated plans, a Pinnacle host script was generated and used to optimize all 14 plans. Dosimetric parameters such as D(2cm), V(20), and the total normal lung volume receiving 50% of the prescription dose were compared. Results: There was a significant decrease in all dosimetric parameters considered in this study. D(2cm) decreased from (53.960 +/− 2.680)% to (51.703 +/− 1.907)% (p&lt;.05). V(20) decreased from (6.629 +/− 1.565)% to (5.213 +/−1.387)% (p&lt;.005) and the total normal lung receiving 50% of the prescription dose decreased from (254.465 +/− 62.853) cm̂3 to (177.068 +/− 45.947) cm̂3 (p&lt;0.004). Conclusions: Respiratory‐gated VMAT has the potential to reduce the dose to normal lung when treating early‐stage NSCLC with SBRT to moving targets with motion greater than 10 mm.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>DOI: 10.1118/1.3612839</identifier><identifier>CODEN: MPHYA6</identifier><language>eng</language><publisher>American Association of Physicists in Medicine</publisher><subject>Cancer ; Dosimetry ; Lungs ; Radiation therapy ; Radiation treatment</subject><ispartof>Medical Physics, 2011-06, Vol.38 (6), p.3693-3693</ispartof><rights>American Association of Physicists in Medicine</rights><rights>2011 American Association of Physicists in Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,776,780,785,786,23909,23910,25118,27901,27902</link.rule.ids></links><search><creatorcontrib>Xhaferllari, I</creatorcontrib><creatorcontrib>Hamelin, N</creatorcontrib><creatorcontrib>Chen, J</creatorcontrib><creatorcontrib>Gaede, S</creatorcontrib><title>SU‐E‐T‐875: The Potential for Respiratory‐Gated VMAT to Reduce the Normal Lung Dose When Treating Early‐Stage Lung Cancer with SBRT</title><title>Medical Physics</title><description>Purpose: To evaluate the dosimetric potential of respiratory‐gated volumetric‐modulated arc therapy (VMAT) to reduce the dose to normal lung when treating early stage non‐small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT). Methods: Seven early‐stage NSCLC patients were retrospectively planned with gated and un‐gated VMAT using Smart Arc (Pinnacle v9.0, Philips Medical Systems, Cleveland, USA). The average 4D‐CT of each patient was used as the planning CT for the un‐gated VMAT plans. A subset average CT that minimized the motion within a 30% gating window was used as the planning CT for the gated VMAT plans. Each VMAT plan consisted of one arc to minimize the delivery time. All plans were prescribed 54 Gy in 3 fractions and all dosimetric parameters satisfied the requirements of our in‐house lung SBRT protocol. In order to avoid dosimetry bias between the gated and un‐gated plans, a Pinnacle host script was generated and used to optimize all 14 plans. Dosimetric parameters such as D(2cm), V(20), and the total normal lung volume receiving 50% of the prescription dose were compared. Results: There was a significant decrease in all dosimetric parameters considered in this study. D(2cm) decreased from (53.960 +/− 2.680)% to (51.703 +/− 1.907)% (p&lt;.05). V(20) decreased from (6.629 +/− 1.565)% to (5.213 +/−1.387)% (p&lt;.005) and the total normal lung receiving 50% of the prescription dose decreased from (254.465 +/− 62.853) cm̂3 to (177.068 +/− 45.947) cm̂3 (p&lt;0.004). Conclusions: Respiratory‐gated VMAT has the potential to reduce the dose to normal lung when treating early‐stage NSCLC with SBRT to moving targets with motion greater than 10 mm.</description><subject>Cancer</subject><subject>Dosimetry</subject><subject>Lungs</subject><subject>Radiation therapy</subject><subject>Radiation treatment</subject><issn>0094-2405</issn><issn>2473-4209</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNp9kNFOwjAUhhujiYhe-Aa91WTYs27r6h0iogkogaGXS-k6mMGVtCWEO1_AxGf0SSwZt3rx5yTnfP-fnB-hSyAdAEhvoEMTCFPKj1ArjBgNopDwY9QihEdBGJH4FJ1Z-04ISWhMWuhrOvv5_O57ZV4pi29xtlR4rJ2qXSVWuNQGT5RdV0Y4bXYeGginCvw66mbYaX8rNlJh503P2nx4x3BTL_C9tgq_LVWNM6OEq_yqL8xq7586sVAN1RO1VAZvK7fE07tJdo5OSrGy6uIw22j20M96j8HwZfDU6w4DCYzxIJaMiyiJuSgokVRSXiQiUQUXMSshTsIyFTKac0HmQARjwApICQBPWFRCGNI2umpypdHWGlXma1N9CLPLgeT7HnPIDz16NmjYbbVSu7_BfDQ-8NcNb2Xl_Oe6_if8F1migxQ</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Xhaferllari, I</creator><creator>Hamelin, N</creator><creator>Chen, J</creator><creator>Gaede, S</creator><general>American Association of Physicists in Medicine</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201106</creationdate><title>SU‐E‐T‐875: The Potential for Respiratory‐Gated VMAT to Reduce the Normal Lung Dose When Treating Early‐Stage Lung Cancer with SBRT</title><author>Xhaferllari, I ; Hamelin, N ; Chen, J ; Gaede, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1779-5c79a4659ad30c3c39d6a6ed9a57f1562f8ac4b9a0b10a7717d180119674f1223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Cancer</topic><topic>Dosimetry</topic><topic>Lungs</topic><topic>Radiation therapy</topic><topic>Radiation treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xhaferllari, I</creatorcontrib><creatorcontrib>Hamelin, N</creatorcontrib><creatorcontrib>Chen, J</creatorcontrib><creatorcontrib>Gaede, S</creatorcontrib><collection>CrossRef</collection><jtitle>Medical Physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xhaferllari, I</au><au>Hamelin, N</au><au>Chen, J</au><au>Gaede, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SU‐E‐T‐875: The Potential for Respiratory‐Gated VMAT to Reduce the Normal Lung Dose When Treating Early‐Stage Lung Cancer with SBRT</atitle><jtitle>Medical Physics</jtitle><date>2011-06</date><risdate>2011</risdate><volume>38</volume><issue>6</issue><spage>3693</spage><epage>3693</epage><pages>3693-3693</pages><issn>0094-2405</issn><eissn>2473-4209</eissn><coden>MPHYA6</coden><abstract>Purpose: To evaluate the dosimetric potential of respiratory‐gated volumetric‐modulated arc therapy (VMAT) to reduce the dose to normal lung when treating early stage non‐small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT). Methods: Seven early‐stage NSCLC patients were retrospectively planned with gated and un‐gated VMAT using Smart Arc (Pinnacle v9.0, Philips Medical Systems, Cleveland, USA). The average 4D‐CT of each patient was used as the planning CT for the un‐gated VMAT plans. A subset average CT that minimized the motion within a 30% gating window was used as the planning CT for the gated VMAT plans. Each VMAT plan consisted of one arc to minimize the delivery time. All plans were prescribed 54 Gy in 3 fractions and all dosimetric parameters satisfied the requirements of our in‐house lung SBRT protocol. In order to avoid dosimetry bias between the gated and un‐gated plans, a Pinnacle host script was generated and used to optimize all 14 plans. Dosimetric parameters such as D(2cm), V(20), and the total normal lung volume receiving 50% of the prescription dose were compared. Results: There was a significant decrease in all dosimetric parameters considered in this study. D(2cm) decreased from (53.960 +/− 2.680)% to (51.703 +/− 1.907)% (p&lt;.05). V(20) decreased from (6.629 +/− 1.565)% to (5.213 +/−1.387)% (p&lt;.005) and the total normal lung receiving 50% of the prescription dose decreased from (254.465 +/− 62.853) cm̂3 to (177.068 +/− 45.947) cm̂3 (p&lt;0.004). Conclusions: Respiratory‐gated VMAT has the potential to reduce the dose to normal lung when treating early‐stage NSCLC with SBRT to moving targets with motion greater than 10 mm.</abstract><pub>American Association of Physicists in Medicine</pub><doi>10.1118/1.3612839</doi><tpages>1</tpages></addata></record>
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subjects Cancer
Dosimetry
Lungs
Radiation therapy
Radiation treatment
title SU‐E‐T‐875: The Potential for Respiratory‐Gated VMAT to Reduce the Normal Lung Dose When Treating Early‐Stage Lung Cancer with SBRT
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