NDLI: Changes in volume of stage I non-small-cell lung cancer during stereotactic body radiotherapy

Content Provider	Springer Nature : BioMed Central
Author	Tatekawa, Kotoha Iwata, Hiromitsu Kawaguchi, Takatsune Ishikura, Satoshi Baba, Fumiya Otsuka, Shinya Miyakawa, Akifumi Iwana, Maho Shibamoto, Yuta
Abstract	Background The overall treatment time of stereotactic body radiotherapy (SBRT) for non-small-cell lung cancer is usually 3 to over 10 days. If it is longer than 7 days, tumor volume expansion during SBRT may jeopardize the target dose coverage. In this study, volume change of stage I NSCLC during SBRT was investigated. Methods Fifty patients undergoing 4-fraction SBRT with a total dose of 48 Gy (n = 36) or 52 Gy (n = 14) were analyzed. CT was taken for registration at the first and third SBRT sessions with an interval of 7 days in all patients. Patient age was 29–87 years (median, 77), and 39 were men. Histology was adenocarcinoma in 28, squamous cell carcinoma in 17, and others in 5. According to the UICC 7th classification, T-stage was T1a in 9 patients, T1b in 27, and T2a in 14. Tumor volumes on the first and 8th days were determined on CT images taken during the exhalation phase, by importing the data into the Dr. View/LINAX image analysis system. After determining the optimal threshold for distinguishing tumor from pulmonary parenchyma, the region above -250 HU was automatically extracted and the tumor volumes were calculated. Results The median tumor volume was 7.3 ml (range, 0.5-35.7) on day 1 and 7.5 ml (range, 0.5-35.7) on day 8. Volume increase of over 10% was observed in 16 cases (32%); increases by >10 to ≤20%, >20 to ≤30%, and >30% were observed in 9, 5, and 2 cases, respectively. The increase in the estimated tumor diameter was over 2 mm in 3 cases and 1–2 mm in 6. A decrease of 10% or more was seen in 3 cases. Among the 16 tumors showing a volume increase of over 10%, T-stage was T1a in 2 patients, T1b in 9, and T2a in 5. Histology was adenocarcinoma in 10 patients, squamous cell carcinoma in 5, and others in 1. Conclusions Volume expansion >10% was observed in 32% of the tumors during the first week of SBRT, possibly due to edema or sustained tumor progression. When planning SBRT, this phenomenon should be taken into account.
Related Links	https://ro-journal.biomedcentral.com/counter/pdf/10.1186/1748-717X-9-8.pdf
Ending Page	5
Page Count	5
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/1748-717X-9-8
Journal	Radiation Oncology
Issue Number	1
Volume Number	9
Language	English
Publisher	BioMed Central
Publisher Date	2014-01-07
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Radiotherapy Imaging Radiology Squamous Cell Carcinoma Tumor Volume Stereotactic Body Radiotherapy Gross Tumor Volume Japan Clinical Oncology Group
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Oncology
Journal Impact Factor	3.3/2023
5-Year Journal Impact Factor	3.6/2023

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