Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.

PURPOSE: To investigate the potential for reduction in normal tissue irradiation by creating a patient specific planning target volume (PTV) using cone beam computed tomography (CBCT) imaging acquired in the first week of radiotherapy for patients receiving radical radiotherapy. METHODS AND MATERIA...

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Main Authors: Hawkins, M, Brooks, C, Hansen, V, Aitken, A, Tait, D
Format: Journal article
Language:English
Published: 2010
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author Hawkins, M
Brooks, C
Hansen, V
Aitken, A
Tait, D
author_facet Hawkins, M
Brooks, C
Hansen, V
Aitken, A
Tait, D
author_sort Hawkins, M
collection OXFORD
description PURPOSE: To investigate the potential for reduction in normal tissue irradiation by creating a patient specific planning target volume (PTV) using cone beam computed tomography (CBCT) imaging acquired in the first week of radiotherapy for patients receiving radical radiotherapy. METHODS AND MATERIALS: Patients receiving radical RT for carcinoma of the esophagus were investigated. The PTV is defined as CTV(tumor, nodes) plus esophagus outlined 3 to 5 cm cranio-caudally and a 1.5-cm circumferential margin is added (clinical plan). Prefraction CBCT are acquired on Days 1 to 4, then weekly. No correction for setup error made. The images are imported into the planning system. The tumor and esophagus for the length of the PTV are contoured on each CBCT and 5 mm margin is added. A composite volume (PTV1) is created using Week 1 composite CBCT volumes. The same process is repeated using CBCT Week 2 to 6 (PTV2). A new plan is created using PTV1 (adaptive plan). The coverage of the 95% isodose of PTV1 is evaluated on PTV2. Dose-volume histograms (DVH) for lungs, heart, and cord for two plans are compared. RESULTS: A total of 139 CBCT for 14 cases were analyzed. For the adaptive plan the coverage of the 95% prescription isodose for PTV1 = 95.6% +/- 4% and the PTV2 = 96.8% +/- 4.1% (t test, 0.19). Lungs V20 (15.6 Gy vs. 10.2 Gy) and heart mean dose (26.9 Gy vs. 20.7 Gy) were significantly smaller for the adaptive plan. CONCLUSIONS: A reduced planning volume can be constructed within the first week of treatment using CBCT. A single plan modification can be performed within the second week of treatment with considerable reduction in organ at risk dose.
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spelling oxford-uuid:5f4ff9d3-dce4-4880-b239-9015d3e14ed42022-03-26T17:46:06ZCone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5f4ff9d3-dce4-4880-b239-9015d3e14ed4EnglishSymplectic Elements at Oxford2010Hawkins, MBrooks, CHansen, VAitken, ATait, D PURPOSE: To investigate the potential for reduction in normal tissue irradiation by creating a patient specific planning target volume (PTV) using cone beam computed tomography (CBCT) imaging acquired in the first week of radiotherapy for patients receiving radical radiotherapy. METHODS AND MATERIALS: Patients receiving radical RT for carcinoma of the esophagus were investigated. The PTV is defined as CTV(tumor, nodes) plus esophagus outlined 3 to 5 cm cranio-caudally and a 1.5-cm circumferential margin is added (clinical plan). Prefraction CBCT are acquired on Days 1 to 4, then weekly. No correction for setup error made. The images are imported into the planning system. The tumor and esophagus for the length of the PTV are contoured on each CBCT and 5 mm margin is added. A composite volume (PTV1) is created using Week 1 composite CBCT volumes. The same process is repeated using CBCT Week 2 to 6 (PTV2). A new plan is created using PTV1 (adaptive plan). The coverage of the 95% isodose of PTV1 is evaluated on PTV2. Dose-volume histograms (DVH) for lungs, heart, and cord for two plans are compared. RESULTS: A total of 139 CBCT for 14 cases were analyzed. For the adaptive plan the coverage of the 95% prescription isodose for PTV1 = 95.6% +/- 4% and the PTV2 = 96.8% +/- 4.1% (t test, 0.19). Lungs V20 (15.6 Gy vs. 10.2 Gy) and heart mean dose (26.9 Gy vs. 20.7 Gy) were significantly smaller for the adaptive plan. CONCLUSIONS: A reduced planning volume can be constructed within the first week of treatment using CBCT. A single plan modification can be performed within the second week of treatment with considerable reduction in organ at risk dose.
spellingShingle Hawkins, M
Brooks, C
Hansen, V
Aitken, A
Tait, D
Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.
title Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.
title_full Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.
title_fullStr Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.
title_full_unstemmed Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.
title_short Cone beam computed tomography-derived adaptive radiotherapy for radical treatment of esophageal cancer.
title_sort cone beam computed tomography derived adaptive radiotherapy for radical treatment of esophageal cancer
work_keys_str_mv AT hawkinsm conebeamcomputedtomographyderivedadaptiveradiotherapyforradicaltreatmentofesophagealcancer
AT brooksc conebeamcomputedtomographyderivedadaptiveradiotherapyforradicaltreatmentofesophagealcancer
AT hansenv conebeamcomputedtomographyderivedadaptiveradiotherapyforradicaltreatmentofesophagealcancer
AT aitkena conebeamcomputedtomographyderivedadaptiveradiotherapyforradicaltreatmentofesophagealcancer
AT taitd conebeamcomputedtomographyderivedadaptiveradiotherapyforradicaltreatmentofesophagealcancer