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Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer.

Publication ,  Journal Article
Liu, HH; Wang, X; Dong, L; Wu, Q; Liao, Z; Stevens, CW; Guerrero, TM; Komaki, R; Cox, JD; Mohan, R
Published in: Int J Radiat Oncol Biol Phys
March 15, 2004

PURPOSE: To investigate the possibility of using intensity-modulated radiotherapy (IMRT) to reduce the irradiated volumes of the normal lung and other critical structures in the treatment of non-small-cell lung cancer (NSCLC) and to investigate the effect of IMRT on the potential of spreading low doses to large volumes of normal tissues in such treatment. METHODS AND MATERIALS: A retrospective treatment planning study was performed to compare IMRT and conventional three-dimensional conformal radiation therapy (3D-CRT) for 10 NSCLC patients (Stage I-IIIB). In the IMRT plans, three to nine coplanar beams were designed to treat 95% of the planning target volume with 63 Gy and to minimize the volumes of the normal lung, esophagus, heart, and spinal cord irradiated above their tolerance doses. The two types of plans were compared with respect to the planning target volume coverage, dose-volume histograms, and other dosimetric indexes of the normal structures. RESULTS: Comparing the nine-beam IMRT plan with the 3D-CRT plan, the percentage of lung volume that received >20 Gy and the mean lung dose were reduced for all cases, with a median reduction of 8% and 2 Gy, respectively. An additional reduction of the >5-Gy volume and >10-Gy volume for the lung and thoracic tissue was more difficult with IMRT, although still possible using fewer beams in IMRT. The integral dose to the entire thorax was equivalent and even reduced for 8 of 10 cases using IMRT. CONCLUSION: It is possible to reduce the volumes of low doses (such as the >10-Gy volume and >20-Gy volume) for thoracic normal tissues using IMRT. The increased integral dose and low-dose volumes can be avoided for IMRT if such concerns are addressed carefully in the inverse planning process and with optimization of the IMRT beam configuration.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

March 15, 2004

Volume

58

Issue

4

Start / End Page

1268 / 1279

Location

United States

Related Subject Headings

  • Spinal Cord
  • Retrospective Studies
  • Radiotherapy, Conformal
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Lung Neoplasms
  • Lung
  • Humans
 

Citation

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MLA
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Liu, H. H., Wang, X., Dong, L., Wu, Q., Liao, Z., Stevens, C. W., … Mohan, R. (2004). Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys, 58(4), 1268–1279. https://doi.org/10.1016/j.ijrobp.2003.09.085
Liu, H Helen, Xiaochun Wang, Lei Dong, Qiuwen Wu, Zhongxing Liao, Craig W. Stevens, Thomas M. Guerrero, Ritsuko Komaki, James D. Cox, and Radhe Mohan. “Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer.Int J Radiat Oncol Biol Phys 58, no. 4 (March 15, 2004): 1268–79. https://doi.org/10.1016/j.ijrobp.2003.09.085.
Liu HH, Wang X, Dong L, Wu Q, Liao Z, Stevens CW, et al. Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2004 Mar 15;58(4):1268–79.
Liu, H. Helen, et al. “Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer.Int J Radiat Oncol Biol Phys, vol. 58, no. 4, Mar. 2004, pp. 1268–79. Pubmed, doi:10.1016/j.ijrobp.2003.09.085.
Liu HH, Wang X, Dong L, Wu Q, Liao Z, Stevens CW, Guerrero TM, Komaki R, Cox JD, Mohan R. Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2004 Mar 15;58(4):1268–1279.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

March 15, 2004

Volume

58

Issue

4

Start / End Page

1268 / 1279

Location

United States

Related Subject Headings

  • Spinal Cord
  • Retrospective Studies
  • Radiotherapy, Conformal
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Lung Neoplasms
  • Lung
  • Humans