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| Home > Publications database > Cone-Beam-CT Guided Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer Enables Quality Assurance and Superior Sparing of Healthy Lung. > print |
| 001 | 166609 | ||
| 005 | 20240229123233.0 | ||
| 024 | 7 | _ | |a 10.3389/fonc.2020.564857 |2 doi |
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| 041 | _ | _ | |a eng |
| 082 | _ | _ | |a 610 |
| 100 | 1 | _ | |a Hoegen, Philipp |0 P:(DE-He78)a8a8a2fe0df558db50514c1b568ca8ff |b 0 |e First author |u dkfz |
| 245 | _ | _ | |a Cone-Beam-CT Guided Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer Enables Quality Assurance and Superior Sparing of Healthy Lung. |
| 260 | _ | _ | |a Lausanne |c 2020 |b Frontiers Media |
| 336 | 7 | _ | |a article |2 DRIVER |
| 336 | 7 | _ | |a Output Types/Journal article |2 DataCite |
| 336 | 7 | _ | |a Journal Article |b journal |m journal |0 PUB:(DE-HGF)16 |s 1626944380_3042 |2 PUB:(DE-HGF) |
| 336 | 7 | _ | |a ARTICLE |2 BibTeX |
| 336 | 7 | _ | |a JOURNAL_ARTICLE |2 ORCID |
| 336 | 7 | _ | |a Journal Article |0 0 |2 EndNote |
| 500 | _ | _ | |a #EA:E050#LA:E050# |
| 520 | _ | _ | |a To evaluate the potential of cone-beam-CT (CB-CT) guided adaptive radiotherapy (ART) for locally advanced non-small cell lung cancer (NSCLC) for sparing of surrounding organs-at-risk (OAR).In 10 patients with locally advanced NSCLC, daily CB-CT imaging was acquired during radio- (n = 4) or radiochemotherapy (n = 6) for simulation of ART. Patients were treated with conventionally fractionated intensity-modulated radiotherapy (IMRT) with total doses of 60-66 Gy (pPlan) (311 fraction CB-CTs). OAR were segmented on every daily CB-CT and the tumor volumes were modified weekly depending on tumor changes. Doses actually delivered were recalculated on daily images (dPlan), and voxel-wise dose accumulation was performed using a deformable registration algorithm. For simulation of ART, treatment plans were adapted using the new contours and re-optimized weekly (aPlan).CB-CT showed continuous tumor regression of 1.1 ± 0.4% per day, leading to a residual gross tumor volume (GTV) of 65.3 ± 13.4% after 6 weeks of radiotherapy (p = 0.005). Corresponding PTVs decreased to 83.7 ± 7.8% (p = 0.005). In the actually delivered plans (dPlan), both conformity (p = 0.005) and homogeneity (p = 0.059) indices were impaired compared to the initial plans (pPlan). This resulted in higher actual lung doses than planned: V20Gy was 34.6 ± 6.8% instead of 32.8 ± 4.9% (p = 0.066), mean lung dose was 19.0 ± 3.1 Gy instead of 17.9 ± 2.5 Gy (p = 0.013). The generalized equivalent uniform dose (gEUD) of the lung was 18.9 ± 3.1 Gy instead of 17.8 ± 2.5 Gy (p = 0.013), leading to an increased lung normal tissue complication probability (NTCP) of 15.2 ± 13.9% instead of 9.6 ± 7.3% (p = 0.017). Weekly plan adaptation enabled decreased lung V20Gy of 31.6 ± 6.2% (-3.0%, p = 0.007), decreased mean lung dose of 17.7 ± 2.9 Gy (-1.3 Gy, p = 0.005), and decreased lung gEUD of 17.6 ± 2.9 Gy (-1.3 Gy, p = 0.005). Thus, resulting lung NTCP was reduced to 10.0 ± 9.5% (-5.2%, p = 0.005). Target volume coverage represented by conformity and homogeneity indices could be improved by weekly plan adaptation (CI: p = 0.007, HI: p = 0.114) and reached levels of the initial plan (CI: p = 0.721, HI: p = 0.333).IGRT with CB-CT detects continuous GTV and PTV changes. CB-CT-guided ART for locally advanced NSCLC is feasible and enables superior sparing of healthy lung at high levels of plan conformity. |
| 536 | _ | _ | |a 315 - Imaging and radiooncology (POF3-315) |0 G:(DE-HGF)POF3-315 |c POF3-315 |f POF III |x 0 |
| 588 | _ | _ | |a Dataset connected to CrossRef, PubMed, |
| 650 | _ | 7 | |a adaptive radiotherapy |2 Other |
| 650 | _ | 7 | |a cone-beam computed tomography |2 Other |
| 650 | _ | 7 | |a lung cancer |2 Other |
| 650 | _ | 7 | |a non-small cell lung cancer |2 Other |
| 650 | _ | 7 | |a normal tissue |2 Other |
| 650 | _ | 7 | |a organs at risk |2 Other |
| 650 | _ | 7 | |a pneumonitis |2 Other |
| 650 | _ | 7 | |a quality assessment |2 Other |
| 700 | 1 | _ | |a Lang, Clemens |0 P:(DE-He78)2c5517db7bc397f9b14ae357a7ce54ff |b 1 |u dkfz |
| 700 | 1 | _ | |a Akbaba, Sati |b 2 |
| 700 | 1 | _ | |a Häring, Peter |0 P:(DE-HGF)0 |b 3 |
| 700 | 1 | _ | |a Splinter, Mona |0 P:(DE-He78)1f74df58d1c0f7b55b5caa01e6c7f806 |b 4 |u dkfz |
| 700 | 1 | _ | |a Miltner, Annette |0 P:(DE-He78)04bc7520e3c0a6bc9e9da40c02bf0f9c |b 5 |u dkfz |
| 700 | 1 | _ | |a Bachmann, Marion |0 P:(DE-He78)ff45bfd5f220fd946ef83485eeb8f2f6 |b 6 |u dkfz |
| 700 | 1 | _ | |a Stahl-Arnsberger, Christiane |0 P:(DE-He78)cec5a69186a0f7c800ab102ed800b6f2 |b 7 |u dkfz |
| 700 | 1 | _ | |a Brechter, Thomas |0 P:(DE-He78)7a69be9eb0e1c9e14864069804b1b82e |b 8 |u dkfz |
| 700 | 1 | _ | |a El Shafie, Rami A |b 9 |
| 700 | 1 | _ | |a Weykamp, Fabian |b 10 |
| 700 | 1 | _ | |a König, Laila |b 11 |
| 700 | 1 | _ | |a Debus, Jürgen |0 P:(DE-He78)8714da4e45acfa36ce87c291443a9218 |b 12 |u dkfz |
| 700 | 1 | _ | |a Hörner-Rieber, Juliane |0 P:(DE-He78)c59ff25b48c192ed3fd4ad3a4bc9b9c0 |b 13 |e Last author |u dkfz |
| 773 | _ | _ | |a 10.3389/fonc.2020.564857 |g Vol. 10, p. 564857 |0 PERI:(DE-600)2649216-7 |p 564857 |t Frontiers in oncology |v 10 |y 2020 |x 2234-943X |
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