Colleen Dickie1, Amy Parent2, Anthony M Griffin3, Jay Wunder4, Peter Ferguson4, Peter W Chung5, Tim Craig5, Michael Sharpe5, Nathan Becker5, David Shultz5, Charles N Catton5, Brian O'Sullivan5. 1. Department of Radiation Oncology, Princess Margaret Cancer Centre, UHN, Toronto, Canada; University of Toronto, Canada. Electronic address: colleen.dickie@rmp.uhn.on.ca. 2. Department of Radiation Oncology, Princess Margaret Cancer Centre, UHN, Toronto, Canada. 3. Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Canada. 4. Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Canada; University of Toronto, Canada. 5. Department of Radiation Oncology, Princess Margaret Cancer Centre, UHN, Toronto, Canada; University of Toronto, Canada.
Abstract
PURPOSE: To determine the value of preoperative adaptive radiotherapy (ART) for soft tissue sarcoma patients (STS) by modeling the dosimetric consequences of tumour volume changes (TVC) using different external beam radiotherapy techniques. METHODS AND MATERIALS: A subset of 22 STS patients from a recent trial (NCT00188175) underwent a repeat CT scan (CT2) prompted by TVC>1cm during IMRT; 14 tumours grew, 8 shrank. Conformal and conventional plans were modelled in addition to IMRT replicating original criteria from the initial planning dataset (CT1):95% PTV encompassed by 97% prescribed dose. CT1 RT parameters for all plans were applied to CT2 for dosimetric assessment of TVC. Co-registration of CT1 and CT2 permitted comparison of original and new contours. RESULTS: Mean TVC was 45% for growing and 33% for the shrinking cohort with TVC prompting CT2 at a mean of 13 fractions. For growers, the lack of target coverage on CT2 was statistically significant but was adequate for shrinkers. CONCLUSION: GTV expansion of >1cm during RT may result in target underdosage independent of RT technique. ART applied offline for TV increases >1cm is a practical adaptive strategy to ensure tumour coverage during RT. TV shrinkage may allow for normal tissue sparing, which should be investigated prospectively.
PURPOSE: To determine the value of preoperative adaptive radiotherapy (ART) for soft tissue sarcomapatients (STS) by modeling the dosimetric consequences of tumour volume changes (TVC) using different external beam radiotherapy techniques. METHODS AND MATERIALS: A subset of 22 STS patients from a recent trial (NCT00188175) underwent a repeat CT scan (CT2) prompted by TVC>1cm during IMRT; 14 tumours grew, 8 shrank. Conformal and conventional plans were modelled in addition to IMRT replicating original criteria from the initial planning dataset (CT1):95% PTV encompassed by 97% prescribed dose. CT1 RT parameters for all plans were applied to CT2 for dosimetric assessment of TVC. Co-registration of CT1 and CT2 permitted comparison of original and new contours. RESULTS: Mean TVC was 45% for growing and 33% for the shrinking cohort with TVC prompting CT2 at a mean of 13 fractions. For growers, the lack of target coverage on CT2 was statistically significant but was adequate for shrinkers. CONCLUSION: GTV expansion of >1cm during RT may result in target underdosage independent of RT technique. ART applied offline for TV increases >1cm is a practical adaptive strategy to ensure tumour coverage during RT. TV shrinkage may allow for normal tissue sparing, which should be investigated prospectively.
Authors: Christian Isaac; John Kavanagh; Anthony Michael Griffin; Colleen I Dickie; Rakesh Mohankumar; Peter W Chung; Charles N Catton; David Shultz; Peter C Ferguson; Jay S Wunder Journal: Br J Radiol Date: 2021-12-03 Impact factor: 3.039
Authors: R Correa; J Gómez-Millán; M Lobato; A Fernández; R Ordoñez; C Castro; Y Lupiañez; J A Medina Journal: Clin Transl Oncol Date: 2018-02-23 Impact factor: 3.405
Authors: Ramiz Abu-Hijlih; Sara Mheid; Fawzi Abuhijla; Wafa Asha; Issa Mohamad; Abdullah Alrashdan; Samer Alheet; Haitham Kana'an; Mohammad Abd Al-Raheem; Abdelatif Almousa Journal: Rep Pract Oncol Radiother Date: 2019-03-18
Authors: Carri K Glide-Hurst; Eric S Paulson; Kiaran McGee; Neelam Tyagi; Yanle Hu; James Balter; John Bayouth Journal: Med Phys Date: 2021-07 Impact factor: 4.071
Authors: Winnie Li; Samuel Appiah; Christine Hill; Nathan Becker; Charles Catton; Peter Chung; David Shultz; Peter Ferguson; Brian O'Sullivan; Colleen Dickie Journal: Tech Innov Patient Support Radiat Oncol Date: 2018-02-04