NDLI: 4DCT and CBCT based PTV margin in Stereotactic Body Radiotherapy(SBRT) of non-small cell lung tumor adhered to chest wall or diaphragm

Content Provider	Springer Nature : BioMed Central
Author	Li, Yi Ma, Jing-lu Chen, Xin Tang, Feng-wen Zhang, Xiao-zhi
Abstract	Background Large tumor motion often leads to larger treatment volumes, especially the lung tumor located in lower lobe and adhered to chest wall or diaphragm. The purpose of this work is to investigate the impacts of planning target volume (PTV) margin on Stereotactic Body Radiotherapy (SBRT) in non-small cell lung cancer (NSCLC). Methods Subjects include 20 patients with the lung tumor located in lower lobe and adhered to chest wall or diaphragm who underwent SBRT. Four-dimensional computed tomography (4DCT) were acquired at simulation to evaluate the tumor intra-fractional centroid and boundary changes, and Cone-beam Computer Tomography (CBCT) were acquired during each treatment to evaluate the tumor inter-fractional set-up displacement. The margin to compensate for tumor variations uncertainties was calculated with various margin calculated recipes published in the exiting literatures. Results The means (±standard deviation) of tumor centroid changes were 0.16 (±0.13) cm, 0.22 (±0.15) cm, and 1.37 (±0.81) cm in RL, AP, and SI directions, respectively. The means (±standard deviation) of tumor edge changes were 0.21 (±0.18) cm, 0.50 (±0.23) cm, and 0.19 (±0.44) cm in RL, AP, and SI directions, respectively. The means (±standard deviation) of tumor set-up displacement were 0.03 (±0.24) cm, 0.02 (±0.26) cm, and 0.02 (±0.43) cm in RL, AP, and SI directions, respectively. The PTV margin to compensate for lung cancer tumor variations uncertainties were 0.88, 0.98 and 2.68 cm in RL, AP and SI directions, which were maximal among all margin recipes. Conclusions 4DCT and CBCT imaging are appropriate to account for the tumor intra-fractional centroid, boundary variations and inter-fractional set-up displacement. The PTV margin to compensate for lung cancer tumor variations uncertainties can be obtained. Our results show that a conventional 1.0 cm margin in the SI plane dose not suffice to compensate the geometrical variety of the tumor located in lower lobe and adhered to chest wall and diaphragm.
Related Links	https://ro-journal.biomedcentral.com/counter/pdf/10.1186/s13014-016-0724-5.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13014-016-0724-5
Journal	Radiation Oncology
Issue Number	1
Volume Number	11
Language	English
Publisher	BioMed Central
Publisher Date	2016-11-15
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Radiotherapy Imaging Radiology 4DCT CBCT SBRT PTV margin NSCLC
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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