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Kraus, K.M. ; Simonetto, C. ; Kundrát, P.* ; Waitz, V.* ; Borm, K.J.* ; Combs, S.E.

Potential morbidity reduction for lung stereotactic body radiation therapy using respiratory gating.

Cancers 13:5092 (2021)
Publ. Version/Full Text Research data DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
We investigated the potential of respiratory gating to mitigate the motion-caused misdos-age in lung stereotactic body radiotherapy (SBRT). For fourteen patients with lung tumors, we investigated treatment plans for a gating window (GW) including three breathing phases around the maximum exhalation phase, GW40-60. For a subset of six patients, we also assessed a preceding three-phase GW20-40 and six-phase GW20-70. We analyzed the target volume, lung, esophagus, and heart doses. Using normal tissue complication probability (NTCP) models, we estimated radiation pneumonitis and esophagitis risks. Compared to plans without gating, GW40-60 significantly reduced doses to organs at risk without impairing the tumor doses. On average, the mean lung dose decreased by 0.6 Gy (p < 0.001), treated lung V20Gy by 2.4% (p = 0.003), esophageal dose to 5cc by 2.0 Gy (p = 0.003), and maximum heart dose by 3.2 Gy (p = 0.009). The model-estimated mean risks of 11% for pneumonitis and 12% for esophagitis without gating decreased upon GW40-60 to 7% and 9%, respectively. For the highest-risk patient, gating reduced the pneumonitis risk from 43% to 32%. Gating is most beneficial for patients with high-toxicity risks. Pre-treatment toxicity risk assessment may help optimize patient selection for gating, as well as GW selection for individual patients.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Lung Cancer ; Motion Management ; Radiation Toxicity ; Radiotherapy Treatment Planning ; Sbrt; Early-stage; Motion Management; Clinical-practice; Radiotherapy; Cancer; Toxicity; Outcomes; Tracking; Tumors; Astro
ISSN (print) / ISBN 2072-6694
Journal Cancers
Quellenangaben Volume: 13, Issue: 20, Pages: , Article Number: 5092 Supplement: ,
Publisher MDPI
Publishing Place St Alban-anlage 66, Ch-4052 Basel, Switzerland
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Medicine (IRM)