AI Article Synopsis

  • The study aimed to validate the dose prescription for stereotactic radiotherapy in lung cancer by analyzing 3D and 4D dose distributions for 94 patients using CT scans during free breathing.
  • An 8 mm margin was added to the internal target volume to establish the planning target volume, and a 2 mm leaf margin was included; the goal was for 99% of the gross tumor volume to receive the full dose based on Monte Carlo calculations.
  • Results showed that the average dose delivered to the tumor was nearly 100% in both the 3D and 4D planning, with no significant difference between the two methods, validating the treatment planning process for clinical applications.

Article Abstract

The purpose of this study was to validate the dose prescription defined to the gross tumor volume (GTV) 3D and 4D dose distributions of stereotactic radiotherapy for lung cancer. Treatment plans for 94 patients were generated based on computed tomography (CT) under free breathing. A uniform margin of 8 mm was added to the internal target volume (ITV) to generate the planning target volume (PTV). A leaf margin of 2 mm was added to the PTV. The prescription dose was defined such that 99% of the GTV should receive 100% of the dose using the Monte Carlo calculation (iPlan RT Dose(TM)) for 6-MV photon beams. The 3D dose distribution was determined using CT under free breathing. The 4D dose distribution plan was recalculated to investigate the effect of tumor motion using the same monitor units as those used for the 3D dose distribution plan. D99 (99% of the GTV) in the 4D plan was defined as the average D99 in each of the four breathing phases (0%, 25%, 50% and 75%). The dose difference between maximum and minimum at D99 of the GTV in 4D calculations was 0.6 ± 1.0% (range 0.2-4.6%). The average D99 of the GTV from 4D calculations in most patients was almost 100% (99.8 ± 1.0%). No significant difference was found in dose to the GTV between 3D and 4D dose calculations (P = 0.67). This study supports the clinical acceptability of treatment planning based on the dose prescription defined to the GTV.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534263PMC
http://dx.doi.org/10.1093/jrr/rrs054DOI Listing

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