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Title: SU-E-T-26: A Dosimetric Comparison of Two Treatment Setups for Lung Stereotactic Body Radiation Therapy (SBRT) Patients

Abstract

Purpose: To assess the feasibility of treating lung SBRT patients with the ipsilateral arm adducted beside the body instead of elevated above the head. Methods: Patients receiving lung SBRT at our institution are typically treated with both arms raised above their head. However, several patients had difficulty maintaining their arms in an elevated position. In this study, lung SBRT patients who underwent PET-CT imaging with an adducted ipsilateral arm were selected to investigate the dosimetric effects of this treatment setup. PET-CT datasets were fused with treatment planning CT images to simulate the adducted arm position. One VMAT treatment plan was created per patient using the Pinnacle treatment planning system. Plans were optimized to achieve minimal dose to the ipsilateral arm while keeping the target coverage and critical structure doses within clinical limits. The target dose coverage, conformity index (CI) for the target, and DVHs of critical structures for the adducted arm plan were calculated. These parameters were compared with the clinical plan and reported along with the mean and maximum doses of the ipsilateral arm. Results: The target coverage, CI and DVHs for the adducted arm plans of two patients (one with peripheral lesion and one with central lesion) weremore » comparable with the clinical plans. Dose constraints for the chest wall limited further reduction of ipsilateral arm doses for the peripheral lesion plan. The mean ipsilateral arm doses for the central and peripheral lesions were 0.33 Gy and 2.4 Gy, respectively. The maximum ipsilateral arm doses for the central and peripheral lesions were 1.0 Gy and 6.2 Gy, respectively. Conclusion: The results suggested patients with central lung SBRT tumors were more suitable for treatment with the adducted arm position. More patients with various lung tumor locations will be studied to find optimal tumor locations for treatment with this arm position.« less

Authors:
; ; ; ; ; ;  [1]
  1. UT MD Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
22545161
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; BIOMEDICAL RADIOGRAPHY; CHEST; COMPUTERIZED TOMOGRAPHY; DATASETS; HEAD; LUNGS; NEOPLASMS; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Lewis, D, Wang, X, Gao, S, Nitsch, P, Pollard, J, Sadagopan, R, and Balter, P. SU-E-T-26: A Dosimetric Comparison of Two Treatment Setups for Lung Stereotactic Body Radiation Therapy (SBRT) Patients. United States: N. p., 2015. Web. doi:10.1118/1.4924387.
Lewis, D, Wang, X, Gao, S, Nitsch, P, Pollard, J, Sadagopan, R, & Balter, P. SU-E-T-26: A Dosimetric Comparison of Two Treatment Setups for Lung Stereotactic Body Radiation Therapy (SBRT) Patients. United States. doi:10.1118/1.4924387.
Lewis, D, Wang, X, Gao, S, Nitsch, P, Pollard, J, Sadagopan, R, and Balter, P. Mon . "SU-E-T-26: A Dosimetric Comparison of Two Treatment Setups for Lung Stereotactic Body Radiation Therapy (SBRT) Patients". United States. doi:10.1118/1.4924387.
@article{osti_22545161,
title = {SU-E-T-26: A Dosimetric Comparison of Two Treatment Setups for Lung Stereotactic Body Radiation Therapy (SBRT) Patients},
author = {Lewis, D and Wang, X and Gao, S and Nitsch, P and Pollard, J and Sadagopan, R and Balter, P},
abstractNote = {Purpose: To assess the feasibility of treating lung SBRT patients with the ipsilateral arm adducted beside the body instead of elevated above the head. Methods: Patients receiving lung SBRT at our institution are typically treated with both arms raised above their head. However, several patients had difficulty maintaining their arms in an elevated position. In this study, lung SBRT patients who underwent PET-CT imaging with an adducted ipsilateral arm were selected to investigate the dosimetric effects of this treatment setup. PET-CT datasets were fused with treatment planning CT images to simulate the adducted arm position. One VMAT treatment plan was created per patient using the Pinnacle treatment planning system. Plans were optimized to achieve minimal dose to the ipsilateral arm while keeping the target coverage and critical structure doses within clinical limits. The target dose coverage, conformity index (CI) for the target, and DVHs of critical structures for the adducted arm plan were calculated. These parameters were compared with the clinical plan and reported along with the mean and maximum doses of the ipsilateral arm. Results: The target coverage, CI and DVHs for the adducted arm plans of two patients (one with peripheral lesion and one with central lesion) were comparable with the clinical plans. Dose constraints for the chest wall limited further reduction of ipsilateral arm doses for the peripheral lesion plan. The mean ipsilateral arm doses for the central and peripheral lesions were 0.33 Gy and 2.4 Gy, respectively. The maximum ipsilateral arm doses for the central and peripheral lesions were 1.0 Gy and 6.2 Gy, respectively. Conclusion: The results suggested patients with central lung SBRT tumors were more suitable for treatment with the adducted arm position. More patients with various lung tumor locations will be studied to find optimal tumor locations for treatment with this arm position.},
doi = {10.1118/1.4924387},
journal = {Medical Physics},
number = 6,
volume = 42,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}