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A treatment planning study comparison between supine and prone position for different lung tumour locations using CyberKnife TPS

Published online by Cambridge University Press:  17 May 2021

Hiroaki Akasaka
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo650-0017, Japan
Kazufusa Mizonobe
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Yuya Oki
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Kazuyuki Uehara
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Aya Harada
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Shuichiro Miyazaki
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Keiji Kitatani
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Tomonori Yabuuchi
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Takeaki Ishihara
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Daisuke Miyawaki
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Masao Nakayama
Affiliation:
Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo650-0017, Japan
Naritoshi Mukumoto
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Ryuichi Yada
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Ai Nakaoka
Affiliation:
Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo650-0017, Japan
Hikaru Kubota
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Hiroki Kawaguchi
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Satoshi Seno
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Ryohei Sasaki
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Hiroshi Mayahara*
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
*
Author for correspondence: Hiroshi Mayahara, Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan. Tel: (+81)-78-304-4100. Fax: (+81)-78-304-0041. E-mail: mayahara@k-mcc.net

Abstract

Aim:

CyberKnife is the most advanced form of stereotactic body radiotherapy (SBRT) system that uses a robotic arm to deliver highly focused beams of radiation; however, a limitation is that it only irradiates from ceiling to floor direction. In patients with posterior lungs tumour who are positioned supine, normal lung tissue may suffer undesirable radiation injuries. This study compares the treatment planning between the prone set-up and the supine set-up for lung cancer in CyberKnife SBRT to decrease normal lung dose to avoid radiation side effects.

Materials and methods:

A human phantom was used to generate 108 plans (54 for prone and 54 for supine) using the CyberKnife planning platform. The supine and prone plans were compared in terms of the dosimetric characteristics, delivery efficiency and plan efficiency.

Results:

For posterior targets, the area of low-dose exposure to normal lungs was smaller in the prone set-up than in the supine set-up. V10 of the lungs was 7·53% and 10·47% (p < 0·001) in the anterior region, and 10·78% and 8·03% (p < 0·001) in the posterior region in the supine and prone set-up plans, respectively.

Conclusions:

The comparison between the prone set-up and the supine set-up was investigated with regard to target coverage and dose to organs at risk. Our results may be deployed in CyberKnife treatment planning to monitor normal tissue dose by considering patient positioning. This may assist in the design of better treatment plans and prevention of symptomatic radiation pneumonitis in lung cancer patients.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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