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Article: Single fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?

TitleSingle fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?
Authors
KeywordsCT-guided brachy
HDR
high-dose-rate
lung cancer
Issue Date2018
PublisherTermedia sp. z o.o.,Termedia Publishing House. The Journal's web site is located at https://www.termedia.pl/Journal/Journal_of_Contemporary_Brachytherapy-54
Citation
Journal of Contemporary Brachytherapy, 2018, v. 10 n. 5, p. 446-453 How to Cite?
AbstractPurpose: To provide a pilot dosimetric study of computed tomography (CT)-guided high-dose-rate (HDR) brachytherapy (BRT) and stereotactic body radiotherapy (SBRT) for primary and metastatic lung lesions. Material and methods: For nine lung primary and metastasis patients, 3D image-based BRT plan using a single virtual catheter was planned for 34 Gy in single fraction to the gross tumor volume (GTV) + 3 mm margin to account for tumor deformation. These plans were compared to margin-based (MB-) and robustness optimized (RO-) SBRT, assuming the same tumor deformation under real-time tumor tracking. Consistent dose calculation was ensured for both BRT and SBRT plans using the same class of collapsed cone convolution superposition algorithm. Plan quality metrics were compared by Friedman tests and Wilcoxon t-tests. Results and Conclusions: Brachytherapy plans showed significant higher GTV mean dose compared to MB- and RO-SBRT (122.2 Gy vs. 50.4 and 44.7 Gy, p < 0.05), and better dose gradient index (R-50) = 2.9 vs. 4.3 and 8.4 for MB- and RO-SBRT, respectively. Dose constraints per the RTOG 0915 protocol were achieved for all critical organs except chest wall in BRT. All other dose-volume histograms (DVH) metrics are comparable between BRT and SBRT. Treatment delivery time of BRT and SBRT plans significantly increased and decreased with increasing GTV size, respectively. SBRT using advanced MLC tracking technique and non-coplanar VMAT can achieve comparable dosimetric quality to HDR BRT. Whether or not, the significantly higher GTV dose can increase killing of radioresistant tumor cells and offset the effect of tumor reoxygenation in single fraction BRT, requires further clinical investigation.
Persistent Identifierhttp://hdl.handle.net/10722/274919
ISSN
2017 Impact Factor: 2.146
2015 SCImago Journal Rankings: 0.451
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, MK-
dc.contributor.authorLee, VW-
dc.contributor.authorKadoya, N-
dc.contributor.authorChiang, CL-
dc.contributor.authorWong, MY-
dc.contributor.authorLeung, RW-
dc.contributor.authorCheung, S-
dc.contributor.authorBlanck, O-
dc.date.accessioned2019-09-10T02:31:36Z-
dc.date.available2019-09-10T02:31:36Z-
dc.date.issued2018-
dc.identifier.citationJournal of Contemporary Brachytherapy, 2018, v. 10 n. 5, p. 446-453-
dc.identifier.issn1689-832X-
dc.identifier.urihttp://hdl.handle.net/10722/274919-
dc.description.abstractPurpose: To provide a pilot dosimetric study of computed tomography (CT)-guided high-dose-rate (HDR) brachytherapy (BRT) and stereotactic body radiotherapy (SBRT) for primary and metastatic lung lesions. Material and methods: For nine lung primary and metastasis patients, 3D image-based BRT plan using a single virtual catheter was planned for 34 Gy in single fraction to the gross tumor volume (GTV) + 3 mm margin to account for tumor deformation. These plans were compared to margin-based (MB-) and robustness optimized (RO-) SBRT, assuming the same tumor deformation under real-time tumor tracking. Consistent dose calculation was ensured for both BRT and SBRT plans using the same class of collapsed cone convolution superposition algorithm. Plan quality metrics were compared by Friedman tests and Wilcoxon t-tests. Results and Conclusions: Brachytherapy plans showed significant higher GTV mean dose compared to MB- and RO-SBRT (122.2 Gy vs. 50.4 and 44.7 Gy, p < 0.05), and better dose gradient index (R-50) = 2.9 vs. 4.3 and 8.4 for MB- and RO-SBRT, respectively. Dose constraints per the RTOG 0915 protocol were achieved for all critical organs except chest wall in BRT. All other dose-volume histograms (DVH) metrics are comparable between BRT and SBRT. Treatment delivery time of BRT and SBRT plans significantly increased and decreased with increasing GTV size, respectively. SBRT using advanced MLC tracking technique and non-coplanar VMAT can achieve comparable dosimetric quality to HDR BRT. Whether or not, the significantly higher GTV dose can increase killing of radioresistant tumor cells and offset the effect of tumor reoxygenation in single fraction BRT, requires further clinical investigation.-
dc.languageeng-
dc.publisherTermedia sp. z o.o.,Termedia Publishing House. The Journal's web site is located at https://www.termedia.pl/Journal/Journal_of_Contemporary_Brachytherapy-54-
dc.relation.ispartofJournal of Contemporary Brachytherapy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCT-guided brachy-
dc.subjectHDR-
dc.subjecthigh-dose-rate-
dc.subjectlung cancer-
dc.titleSingle fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?-
dc.typeArticle-
dc.identifier.emailChiang, CL: chiangcl@hku.hk-
dc.identifier.authorityChiang, CL=rp02241-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5114/jcb.2018.79335-
dc.identifier.pmid30479622-
dc.identifier.hkuros303261-
dc.identifier.volume10-
dc.identifier.issue5-
dc.identifier.spage446-
dc.identifier.epage453-
dc.identifier.isiWOS:000449835300008-
dc.publisher.placePoland-

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