Spanish patterns of care for 3D radiotherapy in non-small-cell lung cancer.
OBJECTIVE
Curative radiotherapy for non-small-cell lung cancer is a difficult challenge, despite the use of conformal radiotherapy. Optimal three-dimensional delineation of treatment volumes is essential for improvement of local control and for limiting of tissue toxicity.


METHODS
A planning course on clinical practice of lung cancer was held in Barcelona. A questionnaire was given concerning (1) patient positioning, (2) planning-computed tomography scan, (3) accounting for tumor mobility, (4) investigative-procedure respiration-gated radiotherapy and breath-holding maneuvers, (5) generation of target volumes, (6) treatment planning, and (7) treatment delivery. This questionnaire was made to determine the Spanish application of European recommendations.


RESULTS
On the negative side, 1 hospital did not use three-dimensional tools, less than 50% used immobilization devices, and 55.6% used computed tomography slices of greater than 5 mm. On the positive side, 70.4% did not use standard margins for gross target volume derived from a computed tomography scan, 92.6% agreed with the inclusion of Naruke anatomic criteria of 1 cm or more in gross target volume planning, and 75% used V20 to estimate the risk of pneumonitis.


CONCLUSIONS
This study is the first validation of European recommendations for treatment planning and execution of radiotherapy in lung cancer. The main conclusion is the need to improve the negative aspects determined.
Casas
Francesc
F
Radiation Oncology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. fcasas@clinic.ub.es
Viñolas
Núria
N
Sanchez-Reyes
Alberto
A
Jorcano
Sandra
S
Planas
Isabel
I
Marruecos
Jordi
J
Pino
Francisco
F
Herreros
Antoni
A
Biete
Albert
A
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D019538:Health Care Surveys; D006801:Humans; D021621:Imaging, Three-Dimensional; D007103:Immobilization / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D009068:Movement; D018787:Radiation Oncology / Q000592:standards*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards*; D020266:Radiotherapy, Conformal / Q000592:standards*; D012119:Respiration; D013030:Spain; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data