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Adaptive planning using positron emission tomography for locally advanced lung cancer: A feasibility study.

Publication ,  Journal Article
Kelsey, CR; Christensen, JD; Chino, JP; Adamson, J; Ready, NE; Perez, BA
Published in: Pract Radiat Oncol
2016

PURPOSE: To evaluate the feasibility of adaptive planning using positron emission tomography-computed tomography (PET-CT) in locally advanced non-small cell lung cancer. METHODS AND MATERIALS: Patients with locally advanced non-small cell lung cancer receiving definitive radiation therapy (RT) were eligible. Initial planning PET-CT was performed and a conventional RT plan (2 Gy/fraction to 60 Gy) was designed. A second planning PET-CT was obtained at ~50 Gy. Dose escalation to ~70 Gy for residual fludeoxyglucose-avid disease was pursued at the discretion of the treating oncologists. The primary endpoint was feasibility of adaptive planning using interim PET-CT. Normal tissue dose-volume parameters were calculated for both adaptive and simulated nonadaptive plans. RESULTS: From 2012 to 2014, 33 eligible patients were enrolled and underwent planning PET-CT, 3 of which were found to have new distant metastases. Of 30 patients who initiated RT, interim PET-CT was obtained in 29. This showed complete response in 2 patients, partial response/stable disease in 24, and new distant metastases in 3. Selective dose escalation was performed in 17 patients. For those receiving a boost, the median gross tumor volumes pre-RT and at ~50 Gy were 78 mL and 29 mL, respectively (P = .01). Reasons for no dose escalation were normal tissue constraints (n = 3), poorly defined residual disease (n = 2), acute toxicity (n = 1), and refusal of further therapy (n = 1). Adaptive planning compared with a simulated nonadaptive approach allowed for significant dose reductions to the lungs, heart, and esophagus (all P < .01). CONCLUSIONS: Adaptive planning using PET-CT was feasible and allows for significant dose reductions to normal tissues compared with traditional planning techniques.

Duke Scholars

Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2016

Volume

6

Issue

2

Start / End Page

96 / 104

Location

United States

Related Subject Headings

  • Radiotherapy Planning, Computer-Assisted
  • Prospective Studies
  • Positron-Emission Tomography
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Feasibility Studies
  • Carcinoma, Non-Small-Cell Lung
 

Citation

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Chicago
ICMJE
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Kelsey, C. R., Christensen, J. D., Chino, J. P., Adamson, J., Ready, N. E., & Perez, B. A. (2016). Adaptive planning using positron emission tomography for locally advanced lung cancer: A feasibility study. Pract Radiat Oncol, 6(2), 96–104. https://doi.org/10.1016/j.prro.2015.10.009
Kelsey, Chris R., Jared D. Christensen, Junzo P. Chino, Justus Adamson, Neal E. Ready, and Bradford A. Perez. “Adaptive planning using positron emission tomography for locally advanced lung cancer: A feasibility study.Pract Radiat Oncol 6, no. 2 (2016): 96–104. https://doi.org/10.1016/j.prro.2015.10.009.
Kelsey CR, Christensen JD, Chino JP, Adamson J, Ready NE, Perez BA. Adaptive planning using positron emission tomography for locally advanced lung cancer: A feasibility study. Pract Radiat Oncol. 2016;6(2):96–104.
Kelsey, Chris R., et al. “Adaptive planning using positron emission tomography for locally advanced lung cancer: A feasibility study.Pract Radiat Oncol, vol. 6, no. 2, 2016, pp. 96–104. Pubmed, doi:10.1016/j.prro.2015.10.009.
Kelsey CR, Christensen JD, Chino JP, Adamson J, Ready NE, Perez BA. Adaptive planning using positron emission tomography for locally advanced lung cancer: A feasibility study. Pract Radiat Oncol. 2016;6(2):96–104.
Journal cover image

Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2016

Volume

6

Issue

2

Start / End Page

96 / 104

Location

United States

Related Subject Headings

  • Radiotherapy Planning, Computer-Assisted
  • Prospective Studies
  • Positron-Emission Tomography
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Feasibility Studies
  • Carcinoma, Non-Small-Cell Lung