scholarly journals Comparative effectiveness of intensity modulated radiation therapy to 3-dimensional conformal radiation in locally advanced lung cancer: pathological and clinical outcomes

2019 ◽  
Vol 92 (1097) ◽  
pp. 20180960 ◽  
Author(s):  
Sarit Appel ◽  
Jair Bar ◽  
Alon Ben-Nun ◽  
Marina Perelman ◽  
Dror Alezra ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Clinical Outcomes ◽  
Comparative Effectiveness ◽  
Locally Advanced ◽  
Intensity Modulated Radiation Therapy ◽  
Advanced Lung Cancer ◽  
3 Dimensional ◽  
Intensity Modulated ◽  
Locally Advanced Lung Cancer

scholarly journals Clinical Application of a Hybrid RapidArc Radiotherapy Technique for Locally Advanced Lung Cancer

2016 ◽  
Vol 16 (2) ◽  
pp. 224-230
Author(s):  
Scott R. Silva ◽  
Murat Surucu ◽  
Jennifer Steber ◽  
Matthew M. Harkenrider ◽  
Mehee Choi
Keyword(s):  
Lung Cancer ◽  
Clinical Application ◽  
Locally Advanced ◽  
Significant Risk ◽  
Conformal Radiotherapy ◽  
Concurrent Chemotherapy ◽  
Advanced Lung Cancer ◽  
3 Dimensional ◽  
Contralateral Lung ◽  
Locally Advanced Lung Cancer

Objective: Radiation treatment planning for locally advanced lung cancer can be technically challenging, as delivery of ≥60 Gy to large volumes with concurrent chemotherapy is often associated with significant risk of normal tissue toxicity. We clinically implemented a novel hybrid RapidArc technique in patients with lung cancer and compared these plans with 3-dimensional conformal radiotherapy and RapidArc-only plans. Materials/Methods: Hybrid RapidArc was used to treat 11 patients with locally advanced lung cancer having bulky mediastinal adenopathy. All 11 patients received concurrent chemotherapy. All underwent a 4-dimensional computed tomography planning scan. Hybrid RapidArc plans concurrently combined static (60%) and RapidArc (40%) beams. All cases were replanned using 3- to 5-field 3-dimensional conformal radiotherapy and RapidArc technique as controls. Results: Significant reductions in dose were observed in hybrid RapidArc plans compared to 3-dimensional conformal radiotherapy plans for total lung V20 and mean (−2% and −0.6 Gy); contralateral lung mean (−2.92 Gy); and esophagus V60 and mean (−16.0% and −2.2 Gy; all P < .05). Contralateral lung doses were significantly lower for hybrid RapidArc plans compared to RapidArc-only plans (all P < .05). Compared to 3-dimensional conformal radiotherapy, heart V60 and mean dose were significantly improved with hybrid RapidArc (3% vs 5%, P = .04 and 16.32 Gy vs 16.65 Gy, P = .03). However, heart V40 and V45 and maximum spinal cord dose were significantly lower with RapidArc plans compared to hybrid RapidArc plans. Conformity and homogeneity were significantly better with hybrid RapidArc plans compared to 3-dimensional conformal radiotherapy plans ( P < .05). Treatment was well tolerated, with no grade 3+ toxicities. Conclusion: To our knowledge, this is the first report on the clinical application of hybrid RapidArc in patients with locally advanced lung cancer. Hybrid RapidArc permitted safe delivery of 60 to 66 Gy to large lung tumors with concurrent chemotherapy and demonstrated advantages for reduction in low-dose lung volumes, esophageal dose, and mean heart dose.

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