Tom Depuydt1, Kenneth Poels2, Dirk Verellen3, Benedikt Engels4, Christine Collen4, Manuela Buleteanu4, Robbe Van den Begin4, Marlies Boussaer4, Michael Duchateau4, Thierry Gevaert4, Guy Storme3, Mark De Ridder3. 1. Radiotherapy Department, UZ Brussel, Vrije Universiteit Brussel, Brussels; Vrije Universiteit Brussel, Medical Imaging and Physical Sciences Group, Faculty of Medicine and Pharmacy; Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. Electronic address: tom.depuydt@uzleuven.be. 2. Vrije Universiteit Brussel, Medical Imaging and Physical Sciences Group, Faculty of Medicine and Pharmacy. 3. Radiotherapy Department, UZ Brussel, Vrije Universiteit Brussel, Brussels; Vrije Universiteit Brussel, Medical Imaging and Physical Sciences Group, Faculty of Medicine and Pharmacy. 4. Radiotherapy Department, UZ Brussel, Vrije Universiteit Brussel, Brussels.
Abstract
PURPOSE: To report on the first clinical application of a real-time tumor tracking (RTTT) solution based on the Vero SBRT gimbaled linac system for treatment of moving tumors. METHODS AND MATERIALS: A first group of 10 SBRT patients diagnosed with NSCLC or oligometastatic disease in lung or liver was treated with the RTTT technique. The PTV volumes and OAR exposure were benchmarked against the widely used ITV approach. Based on data acquired during execution of RTTT treatments, a first review was performed of the process. RESULTS: The 35% PTV volume reduction with RTTT of the studied single lesions SBRT irradiations of small target volumes is expected to result in a small (<1%) reduction of lung or liver NTCP. A GTV-PTV margin of 5.0mm was applied for treatment planning of RTTT. From patient data on residual geometric uncertainties, a CTV-PTV margin of 3.2mm was calculated. Reduction of the GTV-PTV margin below 5.0mm without better understanding of biological definition of tumor boundaries was discouraged. Total treatment times were reduced to 34.4 min on average. CONCLUSION: A considerable PTV volume reduction was achieved applying RTTT and time efficiency for respiratory correlated SBRT was reestablished with Vero RTTT.
PURPOSE: To report on the first clinical application of a real-time tumor tracking (RTTT) solution based on the Vero SBRT gimbaled linac system for treatment of moving tumors. METHODS AND MATERIALS: A first group of 10 SBRT patients diagnosed with NSCLC or oligometastatic disease in lung or liver was treated with the RTTT technique. The PTV volumes and OAR exposure were benchmarked against the widely used ITV approach. Based on data acquired during execution of RTTT treatments, a first review was performed of the process. RESULTS: The 35% PTV volume reduction with RTTT of the studied single lesions SBRT irradiations of small target volumes is expected to result in a small (<1%) reduction of lung or liver NTCP. A GTV-PTV margin of 5.0mm was applied for treatment planning of RTTT. From patient data on residual geometric uncertainties, a CTV-PTV margin of 3.2mm was calculated. Reduction of the GTV-PTV margin below 5.0mm without better understanding of biological definition of tumor boundaries was discouraged. Total treatment times were reduced to 34.4 min on average. CONCLUSION: A considerable PTV volume reduction was achieved applying RTTT and time efficiency for respiratory correlated SBRT was reestablished with Vero RTTT.
Authors: Marco Mueller; Per Poulsen; Rune Hansen; Wilko Verbakel; Ross Berbeco; Dianne Ferguson; Shinichiro Mori; Lei Ren; John C Roeske; Lei Wang; Pengpeng Zhang; Paul Keall Journal: Med Phys Date: 2021-12-29 Impact factor: 4.071
Authors: Hannah Bainbridge; Ahmed Salem; Rob H N Tijssen; Michael Dubec; Andreas Wetscherek; Corinne Van Es; Jose Belderbos; Corinne Faivre-Finn; Fiona McDonald Journal: Transl Lung Cancer Res Date: 2017-12
Authors: Charles A Kunos; Jeffrey M Fabien; John P Shanahan; Christine Collen; Thierry Gevaert; Kenneth Poels; Robbe Van den Begin; Benedikt Engels; Mark De Ridder Journal: J Vis Exp Date: 2015-06-07 Impact factor: 1.355