The utility of non-axial treatment beam orientations for lower lobe lung cancers.

Published

Journal Article

Traditional treatment beams for non-small-cell lung cancer are limited to the axial plane. For many tumor geometries, non-axial orientations appear to reduce the dose to normal tissues (e.g. heart, liver). We hypothesize that non-axial beams provide a significant reduction in incidental irradiation of the heart and liver, while maintaining adequate target coverage. CT scans of twenty-four patients with lower lobe lung cancers were studied. For each patient, an opposed oblique axial beam pair and a competing non-axial opposed oblique pair were generated, both off-cord. The competing plans delivered comparable doses/margins to the GTV. DVHs and integral doses were computed for all structures of interest for the two competing plans. The integral dose was compared for axial and non-axial beams for each contoured organ using a paired t-test. Dose to the heart was significantly lower for the non-axial plans ( p = .0001). For 20/24 patients, the integral heart dose was reduced by using non-axial beams. In those patients with tumors located in the inferior right lower lobe, a lower dose to the liver was achieved when non-axial beams were used. There were no meaningful differences in dose to the GTV, lungs, or skin between axial and non-axial beams. Non-axial beams can reduce the dose to the heart and liver in patients with lower lobe lung cancers. Non-axial beams may be clinically beneficial in these patients and should be considered as an option during planning.

Full Text

Duke Authors

Cited Authors

  • Quaranta, BP; Das, SK; Shafman, TD; Light, KL; Marks, LB

Published Date

  • January 28, 2010

Published In

Volume / Issue

  • 11 / 1

Start / End Page

  • 3010 -

PubMed ID

  • 20160689

Pubmed Central ID

  • 20160689

Electronic International Standard Serial Number (EISSN)

  • 1526-9914

International Standard Serial Number (ISSN)

  • 1526-9914

Digital Object Identifier (DOI)

  • 10.1120/jacmp.v11i1.3010

Language

  • eng