BACKGROUND AND PURPOSE: Conebeam-CT (CBCT) guidance is often used for setup verification of lung cancer patients treated with radiotherapy. The purpose of this study was to quantify intra-thoracic anatomical changes (ITACs) during the radiotherapy treatment and to hand over a decision support system to guide the radiation therapy technologist and radiation oncologist in prioritizing these changes. MATERIALS AND METHODS: 1793 CBCT-scans of 177 lung cancer patients treated in 2010 in our institute with radical radiotherapy were evaluated. Our decision support system: "the Traffic Light Protocol", was retrospectively applied to these CBCT-scans. The protocol has four levels: red (immediate action before treatment), orange (action before next fraction), yellow (no action required) and green (no change). RESULTS: In 128 patients (72%), 210 ITACs were observed with a maximum level of red, orange and yellow in 12%, 36% and 24% respectively. Types of observed ITACs were, tumor regression (35%), tumor baseline shift (27%), changes in atelectasis (19%), tumor progression (10%), pleural effusion (6%) and infiltrative changes (3%). CONCLUSIONS: ITACs have been observed in 72% of all lung cancer patients during the course of radical radiotherapy. The clinical relevance of the proposed ITAC classification in lung radiotherapy needs to be validated in a prospective analysis.
BACKGROUND AND PURPOSE: Conebeam-CT (CBCT) guidance is often used for setup verification of lung cancerpatients treated with radiotherapy. The purpose of this study was to quantify intra-thoracic anatomical changes (ITACs) during the radiotherapy treatment and to hand over a decision support system to guide the radiation therapy technologist and radiation oncologist in prioritizing these changes. MATERIALS AND METHODS: 1793 CBCT-scans of 177 lung cancerpatients treated in 2010 in our institute with radical radiotherapy were evaluated. Our decision support system: "the Traffic Light Protocol", was retrospectively applied to these CBCT-scans. The protocol has four levels: red (immediate action before treatment), orange (action before next fraction), yellow (no action required) and green (no change). RESULTS: In 128 patients (72%), 210 ITACs were observed with a maximum level of red, orange and yellow in 12%, 36% and 24% respectively. Types of observed ITACs were, tumor regression (35%), tumor baseline shift (27%), changes in atelectasis (19%), tumor progression (10%), pleural effusion (6%) and infiltrative changes (3%). CONCLUSIONS: ITACs have been observed in 72% of all lung cancerpatients during the course of radical radiotherapy. The clinical relevance of the proposed ITAC classification in lung radiotherapy needs to be validated in a prospective analysis.
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: Jason K Molitoris; Tejan Diwanji; James W Snider; Sina Mossahebi; Santanu Samanta; Shahed N Badiyan; Charles B Simone; Pranshu Mohindra Journal: J Thorac Dis Date: 2018-08 Impact factor: 2.895
Authors: Matthew P Deek; Sairaman Nagarajan; Sinae Kim; Inaya Ahmed; Shiby Paul; Eli D Scher; Matthew Listo; Andrew Chen; Joseph Aisner; Sabiha Hussain; Bruce G Haffty; Salma K Jabbour Journal: Acta Oncol Date: 2016-05-24 Impact factor: 4.089