Anand Mahadevan1, Bahman Emami2, Jimm Grimm1, Lawrence R Kleinberg3, Kristin J Redmond3, James S Welsh2, Robert Rostock1, Eric Kemmerer1, Kenneth M Forster1, Jason Stanford1, Sunjay Shah4, Sucha O Asbell5, Tamara A LaCouture5, Carla Scofield1, Ian Butterwick1, Jinyu Xue6, Alexander Muacevic7, John R Adler8. 1. Department of Radiation Oncology, Geisinger Cancer Institute, Danville, PA, United States. 2. Department of Radiation Oncology, Loyola University Medical Center, Chicago, IL, United States. 3. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States. 4. Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States. 5. Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, United States. 6. Department of Radiation Oncology, New York University, New York City, NY, United States. 7. European Cyberknife Center Munich, Munich, Germany. 8. Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States.
Abstract
OBJECTIVE: To determine the long-term normal tissue complication probability with stereotactic body radiation therapy (SBRT) treatments for targets that move with respiration and its relation with the type of respiratory motion management (tracking vs. compression or gating). METHODS: A PubMed search was performed for identifying literature regarding dose, volume, fractionation, and toxicity (grade 3 or higher) for SBRT treatments for tumors which move with respiration. From the identified papers logistic or probit dose-response models were fitted to the data using the maximum-likelihood technique and confidence intervals were based on the profile-likelihood method in the dose-volume histogram (DVH) Evaluator. RESULTS: Pooled logistic and probit models for grade 3 or higher toxicity for aorta, chest wall, duodenum, and small bowel suggest a significant difference when live motion tracking was used for targeting tumors with move with respiration which was on the average 10 times lower, in the high dose range. CONCLUSION: Live respiratory motion management appears to have a better toxicity outcome when treating targets which move with respiration with very steep peripheral dose gradients. This analysis is however limited by sparsity of rigorous data due to poor reporting in the literature.
OBJECTIVE: To determine the long-term normal tissue complication probability with stereotactic body radiation therapy (SBRT) treatments for targets that move with respiration and its relation with the type of respiratory motion management (tracking vs. compression or gating). METHODS: A PubMed search was performed for identifying literature regarding dose, volume, fractionation, and toxicity (grade 3 or higher) for SBRT treatments for tumors which move with respiration. From the identified papers logistic or probit dose-response models were fitted to the data using the maximum-likelihood technique and confidence intervals were based on the profile-likelihood method in the dose-volume histogram (DVH) Evaluator. RESULTS: Pooled logistic and probit models for grade 3 or higher toxicity for aorta, chest wall, duodenum, and small bowel suggest a significant difference when live motion tracking was used for targeting tumors with move with respiration which was on the average 10 times lower, in the high dose range. CONCLUSION: Live respiratory motion management appears to have a better toxicity outcome when treating targets which move with respiration with very steep peripheral dose gradients. This analysis is however limited by sparsity of rigorous data due to poor reporting in the literature.
Authors: Robert W Mutter; Fan Liu; Andres Abreu; Ellen Yorke; Andrew Jackson; Kenneth E Rosenzweig Journal: Int J Radiat Oncol Biol Phys Date: 2011-08-23 Impact factor: 7.038
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