And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept
The internal organ at risk volume (IRV) concept might improve toxicity profiles in stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC). We studied (1) clinical aspects in central vs. peripheral tumors, (2) the IRV concept in central tumors, (3) organ motion, and (4) ass...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/1/231 |
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| author | Felix-Nikolai Oschinka Jegor Habermann Daniela Schmitt Thomas Failing David Alexander Ziegler Jann Fischer Laura Anna Fischer Manuel Guhlich Stephanie Bendrich Olga Knaus Tobias Raphael Overbeck Hannes Treiber Alexander von Hammerstein-Equord Raphael Koch Rami El Shafie Stefan Rieken Martin Leu Leif Hendrik Dröge |
| author_facet | Felix-Nikolai Oschinka Jegor Habermann Daniela Schmitt Thomas Failing David Alexander Ziegler Jann Fischer Laura Anna Fischer Manuel Guhlich Stephanie Bendrich Olga Knaus Tobias Raphael Overbeck Hannes Treiber Alexander von Hammerstein-Equord Raphael Koch Rami El Shafie Stefan Rieken Martin Leu Leif Hendrik Dröge |
| author_sort | Felix-Nikolai Oschinka Jegor Habermann |
| collection | DOAJ |
| description | The internal organ at risk volume (IRV) concept might improve toxicity profiles in stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC). We studied (1) clinical aspects in central vs. peripheral tumors, (2) the IRV concept in central tumors, (3) organ motion, and (4) associated normal tissue complication probabilities (NTCPs). We analyzed patients who received SBRT for NSCLC (clinical aspects, <i>n</i> = 78; motion management, <i>n</i> = 35). We found lower biologically effective doses, larger planning target volume sizes, higher lung doses, and worse locoregional control for central vs. peripheral tumors. Organ motion was greater in males and tall patients (bronchial tree), whereas volume changes were lower in patients with a high body mass index (BMI) (esophagus). Applying the IRV concept (retrospectively, without new optimization), we found an absolute increase of >10% in NTCPs for the bronchial tree in three patients. This study emphasizes the need to optimize methods to balance dose escalation with toxicities in central tumors. There is evidence that organ motion/volume changes could be more pronounced in males and tall patients, and less pronounced in patients with higher BMI. Since recent studies have made efforts to further subclassify central tumors to refine treatment, the IRV concept should be considered for optimal risk assessment. |
| first_indexed | 2024-03-08T15:10:17Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T15:10:17Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4bbf314fb2d046abb06da034af149b112024-01-10T14:53:07ZengMDPI AGCancers2072-66942024-01-0116123110.3390/cancers16010231And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) ConceptFelix-Nikolai Oschinka Jegor Habermann0Daniela Schmitt1Thomas Failing2David Alexander Ziegler3Jann Fischer4Laura Anna Fischer5Manuel Guhlich6Stephanie Bendrich7Olga Knaus8Tobias Raphael Overbeck9Hannes Treiber10Alexander von Hammerstein-Equord11Raphael Koch12Rami El Shafie13Stefan Rieken14Martin Leu15Leif Hendrik Dröge16Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyGöttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, GermanyGöttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, GermanyGöttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, GermanyGöttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyDepartment of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyThe internal organ at risk volume (IRV) concept might improve toxicity profiles in stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC). We studied (1) clinical aspects in central vs. peripheral tumors, (2) the IRV concept in central tumors, (3) organ motion, and (4) associated normal tissue complication probabilities (NTCPs). We analyzed patients who received SBRT for NSCLC (clinical aspects, <i>n</i> = 78; motion management, <i>n</i> = 35). We found lower biologically effective doses, larger planning target volume sizes, higher lung doses, and worse locoregional control for central vs. peripheral tumors. Organ motion was greater in males and tall patients (bronchial tree), whereas volume changes were lower in patients with a high body mass index (BMI) (esophagus). Applying the IRV concept (retrospectively, without new optimization), we found an absolute increase of >10% in NTCPs for the bronchial tree in three patients. This study emphasizes the need to optimize methods to balance dose escalation with toxicities in central tumors. There is evidence that organ motion/volume changes could be more pronounced in males and tall patients, and less pronounced in patients with higher BMI. Since recent studies have made efforts to further subclassify central tumors to refine treatment, the IRV concept should be considered for optimal risk assessment.https://www.mdpi.com/2072-6694/16/1/231NSCLCSBRTcentral tumorsclinical outcomesclinical characteristicsmotion management |
| spellingShingle | Felix-Nikolai Oschinka Jegor Habermann Daniela Schmitt Thomas Failing David Alexander Ziegler Jann Fischer Laura Anna Fischer Manuel Guhlich Stephanie Bendrich Olga Knaus Tobias Raphael Overbeck Hannes Treiber Alexander von Hammerstein-Equord Raphael Koch Rami El Shafie Stefan Rieken Martin Leu Leif Hendrik Dröge And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept Cancers NSCLC SBRT central tumors clinical outcomes clinical characteristics motion management |
| title | And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept |
| title_full | And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept |
| title_fullStr | And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept |
| title_full_unstemmed | And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept |
| title_short | And Yet It Moves: Clinical Outcomes and Motion Management in Stereotactic Body Radiation Therapy (SBRT) of Centrally Located Non-Small Cell Lung Cancer (NSCLC): Shedding Light on the Internal Organ at Risk Volume (IRV) Concept |
| title_sort | and yet it moves clinical outcomes and motion management in stereotactic body radiation therapy sbrt of centrally located non small cell lung cancer nsclc shedding light on the internal organ at risk volume irv concept |
| topic | NSCLC SBRT central tumors clinical outcomes clinical characteristics motion management |
| url | https://www.mdpi.com/2072-6694/16/1/231 |
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