title: High-dose-rate Three-dimensional Conformal Radiotherapy Combined with Active Breathing Control for Stereotactic Body Radiotherapy of Early-stage Non-small-cell Lung Cancer.
abstract: The purpose of this study was to evaluate the feasibility and benefits of using high-dose-rate three-dimensional conformal radiotherapy (3D-CRT) combined with active breathing control (ABC) for stereotactic body radiotherapy (SBRT) of patients with early-stage non-small-cell lung cancer (NSCLC). Eight patients with early-stage NSCLC underwent CT scans under standard free-breathing (FB) and moderately deep inspiration breath-hold (mDIBH) with ABC. Two high-dose-rate 3D-CRT plans (1000 Mu/min) were designed based on the CT scans with FB and mDIBH. The maximal dose (D1%), minimal dose (D99%), conformity index (CI), and homogeneity index (HI) of the planning target volume (PTV), and dose-volume indices of the organs at risk between each plan were compared. The mean PTV volume decreased from 158.04 cm(3) with FB to 76.90 cm(3) with mDIBH (p < 0.05). When mDIBH was used, increases in the affected lung volume (by 47%), contralateral lung volume (by 55%), and total lung volume (by 50%) were observed compared to FB (p < 0.05). The V5-V40 of the affected lung (Vx represented the percentage volume of organs receiving at least the x Gy), V5-V40 and the mean dose for the total lung, V5-V40 and mean dose of the chest wall, and the maximum dose of the spinal cord were less for mDIBH than FB (p < 0.05). There were no significant differences in CI, HI, D1%, or D99% for the PTV between the plans. In conclusion, high-dose-rate 3D-CRT combined with ABC reduced the radiation dose to the lungs and chest wall without affecting the dose distribution in SBRT of early-stage NSCLC patients.
authors.affiliation: Post-doctoral Mobile Stations of Tianjin Medical University, Tianjin 300070, P.R. China Department of Radiation Oncology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830054, P.R. China Authors contributed equally.
authors.forename: Ruozheng
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital, Jinan 250117, P.R. China Authors contributed equally.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Radiation Oncology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830054, P.R. China.
authors.forename: Yonghui
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital, Jinan 250117, P.R. China sdyujinming@126.com.
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D062485:Breath Holding; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods; D012119:Respiration
keywords: Active breathing control; Lung cancer; Radiotherapy; Stereotactic body radiotherapy