title: Non-small-cell lung cancer: dose escalation by target splitting with asymmetric collimation.
abstract: In order to increase conformation, the target volume is split into a cranial and a caudal part. Both volumes are planned and treated completely independent, using half-collimated fields to prevent over- or under-dosages in the junction plane. In comparison with conventional techniques, the irradiated volume of normal ipsilateral lung tissues at dose levels >or= 65 Gy, >or= 45 Gy, and >or= 20 Gy can be lowered to values of 37%, 49%, and 86%, respectively; other organs at risk, such as the heart and esophagus, can also be significantly spared. From December 1995 to December 1999, 54 non-small-cell lung cancer patients were treated with doses > 80 Gy (mean, 86.3 Gy; range 80.1-94.9 Gy, International Commission on Radiation Units and Measurements). Twenty-two patients were stage I or stage II, and 32 patients were stage III. Fifteen of the 32 stage III patients received chemotherapy before radiotherapy. Only 1 patient showed a transient grade 3 toxicity (pneumonitis), and at the time of this review, no grade 4/5 toxicity has been observed.
authors.affiliation: Landesklinik für Radiotherapie und Radio-Onkologie, Landeskliniken Salzburg, Austria. k.wurstbauer@lks.at
authors.forename: K
authors.initials: K
authors.lastname: Wurstbauer
authors.forename: H
authors.initials: H
authors.lastname: Deutschmann
authors.forename: F
authors.initials: F
authors.lastname: Sedlmayer
authors.forename: H D
authors.initials: HD
authors.lastname: Kogelnik