BACKGROUND: There is a great deal of excitement regarding respiratory gated radiotherapy (RGRT), however there remain potential errors and controversies surrounding its use. We aim to predict an improvement in the clinical outcome of RGRT in comparison with that of continuous (non-gated) irradiation by analysing toxicity parameters. MATERIALS AND METHODS: The 4DCT scans of 15 patients, with node-positive lung cancer and > 5 mm of tumour movement, were used for this retrospective analysis. End-inspiration and end-expiration plans were created and the toxicity parameters were compared to continuous (non-gated) 4DCT plans. RESULTS: Median reduction in V20 with inspiratory gating and expiratory gating, using a 10mm set-up margin, was 2.0% (range 0.7% to 3.9%) and 0.6% (range -1.1% to 4.7%), respectively. The reduction in MLD was 2.1 Gy (range 0.6 to 3.9 Gy) and 1.6 Gy (range -1.0 to 3.9 Gy), respectively. CONCLUSIONS: Although there is a widespread excitement regarding this technique, this study demonstrates that there is limited reduction in toxicity parameters with the use of RGRT in comparison with continuous (non-gated) 4DCT irradiation. Due to the additional potential errors involved in RGRT, we feel that currently, it should only be performed if comparative planning of RGRT plans and continuous (non-gated) 4DCT plans has been undertaken and a likely clinical benefit has been confirmed. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
BACKGROUND: There is a great deal of excitement regarding respiratory gated radiotherapy (RGRT), however there remain potential errors and controversies surrounding its use. We aim to predict an improvement in the clinical outcome of RGRT in comparison with that of continuous (non-gated) irradiation by analysing toxicity parameters. MATERIALS AND METHODS: The 4DCT scans of 15 patients, with node-positive lung cancer and > 5 mm of tumour movement, were used for this retrospective analysis. End-inspiration and end-expiration plans were created and the toxicity parameters were compared to continuous (non-gated) 4DCT plans. RESULTS: Median reduction in V20 with inspiratory gating and expiratory gating, using a 10mm set-up margin, was 2.0% (range 0.7% to 3.9%) and 0.6% (range -1.1% to 4.7%), respectively. The reduction in MLD was 2.1 Gy (range 0.6 to 3.9 Gy) and 1.6 Gy (range -1.0 to 3.9 Gy), respectively. CONCLUSIONS: Although there is a widespread excitement regarding this technique, this study demonstrates that there is limited reduction in toxicity parameters with the use of RGRT in comparison with continuous (non-gated) 4DCT irradiation. Due to the additional potential errors involved in RGRT, we feel that currently, it should only be performed if comparative planning of RGRT plans and continuous (non-gated) 4DCT plans has been undertaken and a likely clinical benefit has been confirmed. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Authors: Markus Oechsner; Barbara Chizzali; Michal Devecka; Stefan Münch; Stephanie Elisabeth Combs; Jan Jakob Wilkens; Marciana Nona Duma Journal: Strahlenther Onkol Date: 2017-07-19 Impact factor: 3.621
Authors: Markus Oechsner; Barbara Chizzali; Michal Devecka; Stephanie Elisabeth Combs; Jan Jakob Wilkens; Marciana Nona Duma Journal: Radiat Oncol Date: 2016-10-26 Impact factor: 3.481
Authors: Yvonne Dzierma; Frank G Nuesken; Jochen Fleckenstein; Stephanie Kremp; Norbert P Licht; Christian Ruebe Journal: PLoS One Date: 2013-01-10 Impact factor: 3.240