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Selection of patient for gated treatment based on the information from 4DCT imaging in stereotactic body radiotherapy of non-small cell lung cancer

Published online by Cambridge University Press:  14 November 2018

N. V. N. Madhusudhana Sresty Open the ORCID record for N. V. N. Madhusudhana Sresty [Opens in a new window] ,
A. Krishnam Raju ,
S. D. Sharma ,
T. Anil Kumar ,
Shabbir Ahamed  and
Harjot Kaur Bajwa
N. V. N. Madhusudhana Sresty*
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
A. Krishnam Raju
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
S. D. Sharma
Affiliation:
Radiological Physics & Advisory Division, Bhabha Atomic Research Center, Mumbai, India, Research conducted atBasavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
T. Anil Kumar
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
Shabbir Ahamed
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
Harjot Kaur Bajwa
Affiliation:
Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
*
Author for correspondence: Dr N. V. N. Madhusudhana Sresty, Head—Medical Physics, Department of Radiotherapy, Basavatarakam Indo American Cancer Hospital & Research Institute, Road No: 14, Banjara Hills, Hyderabad 500034, India. Tel:+91- 9985151221, Fax: 040-23542120. E-mail: srestybarc@gmail.com
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Abstract

Purpose

Stereotactic body radiotherapy (SBRT) is widely used for the treatment of stage-I non-small cell lung cancer (NSCLC). Patient-specific motion correlated with 4DCT could be essential for hypofractionated SBRT. All patients undergoing SBRT do not require motion management during the dose delivery. The objective of this study was to evaluate which patient may benefit from Gated SBRT.

Materials and methods

Treatment planning of 20 patients of stage-I NSCLC was analysed. Conventional and 4DCT scans were taken. Internal target volume as well as planning target volume (ITV and PTV) were determined in the CT data sets. PTVall phases created using 4DCT data sets and PTV15mm created using conventional CT data were compared. Also, ITVall phases were compared with ITV created from maximum intensity projections (ITVMIP). Suitability of patients for motion management-based treatment delivery was also evaluated.

Results

The average ITVMIP to ITVall phases ratio is 1·06 indicating good agreement between them. Based on the ratio of intensity projections, 9 out of 17 patients were found suitable for our existing gated treatment.

Conclusion

4D CT is the main requirement in SBRT to identify the patients who can benefit from motion management during the dose delivery.

Keywords

4DCTgatinglung cancermotion managementSBRT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 2 , June 2019 , pp. 175 - 179
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Sresty NVNM, Raju AK, Sharma SD, Kumar TA, Ahamed S, Bajwa HK. (2019) Selection of patient for gated treatment based on the information from 4DCT imaging in stereotactic body radiotherapy of non-small cell lung cancer. Journal of Radiotherapy in Practice18: 175–179. doi: 10.1017/S1460396918000614

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