Comprehensive Evaluation of Treatment Plans in Stereotactic Body Radiation Therapy (SBRT) for Lung Cancer Patients
DOI:
https://doi.org/10.22399/ijcesen.1033Keywords:
Non-Small Cell Lung Cancer (NSCLC), Stereotactic Body Radiotherapy (SBRT), Organ at Risk (OAR), Conformity Index (CI), Heterogeneity Index (HI)Abstract
Non-Small Cell Lung Cancer (NSCLC) is a major public health problem and a leading cause of cancer-related deaths. Stereotactic Body Radiotherapy (SBRT) has emerged as a highly precise treatment modality that provides high biologically effective doses (BED) with superior dose compliance, high conformity and sharp dose falloff, and has an important place in the treatment of NSCLC. This study aims to evaluate the SBRT plans for 22 NSCLC patients by assessing the Conformity Index (CI), Heterogeneity Index (HI) and organs at risk (OAR) doses.
Findings demonstrate that SBRT is effective in achieving tumor control in hypoxic and radio resistant tumor regions through precise target coverage and effective intra tumor dose heterogeneity. These features make SBRT a noninvasive and highly effective alternative to surgery for patients with early-stage NSCLC. This study highlights the unique effect of SBRT, a radiotherapy option that reduces doses to organs at risk while improving treatment outcomes, in the treatment of NSCLC and highlights its unique potential in the treatment of NSCLC by evaluating its dosimetric parameters.
References
[1]Andruska, N., Stowe, H. B., Crockett, C., et al. (2021). Stereotactic radiation for lung cancer: A practical approach to challenging scenarios. Journal of Thoracic Oncology, 16(7), 1075-1085. https://doi.org/10.1016/j.jtho.2021.04.002 DOI: https://doi.org/10.1016/j.jtho.2021.04.002
[2]Potters, L., Kavanagh, B., Galvin, J. M., et al. (2010). American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) practice guidelines for the performance of stereotactic body radiation therapy. International Journal of Radiation Oncology Biology Physics, 76(2), 326-332. https://doi.org/10.1016/j.ijrobp.2009.04.043 DOI: https://doi.org/10.1016/j.ijrobp.2009.09.042
[3]Palma, D., Visser, O., Lagerwaard, F. J., et al. (2010). Impact of introducing stereotactic lung radiotherapy for elderly patients with stage I non-small-cell lung cancer: A population-based time-trend analysis. Journal of Clinical Oncology, 28, 5153-5159. https://doi.org/10.1200/JCO.2010.29.8699 DOI: https://doi.org/10.1200/JCO.2010.30.0731
[4]Moreno, A. C., Fellman, B., Hobbs, B. P., et al. (2020). Biologically effective dose in stereotactic body radiotherapy and survival for patients with early-stage NSCLC. Journal of Thoracic Oncology, 15(1),101-109. https://doi.org/10.1016/j.jtho.2019.09.004 DOI: https://doi.org/10.1016/j.jtho.2019.08.2505
[5]Rusthoven, K. E., Kavanagh, B. D., Burri, S. H., et al. (2009). Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases. Journal of Clinical Oncology, 27(10), 1579-1584. https://doi.org/10.1200/JCO.2008.19.5419 DOI: https://doi.org/10.1200/JCO.2008.19.6386
[6]Yanik, R. (2024). Evaluation of treatment plans of lung SBRT patients. Oral presentation presented at: TFD 40 Congress, September 2-6, Bodrum, Turkey. (No DOI available for this presentation)
[7]Onishi, H., Shirato, H., Nagata, Y., et al. (2011). Stereotactic body radiotherapy (SBRT) for operable stage I non-small-cell lung cancer: Can SBRT be comparable to surgery? International Journal of Radiation Oncology Biology Physics, 81(5), 1352-1358. https://doi.org/10.1016/j.ijrobp.2010.08.011 DOI: https://doi.org/10.1016/j.ijrobp.2009.07.1751
[8]Zhang, B., Zhu, F., Ma, X., et al. (2014). Matched-pair comparisons of stereotactic body radiotherapy (SBRT) versus surgery for the treatment of early-stage non-small-cell lung cancer: A systematic review and meta-analysis. Radiotherapy and Oncology, 112(2), 250-255. https://doi.org/10.1016/j.radonc.2014.03.003 DOI: https://doi.org/10.1016/j.radonc.2014.08.031
[9]Ibraheim, M. H., Hanafy, M. S., El-Shahat, K. M., et al. (2023). Dosimetric comparative study between single and dual isocenter stereotactic body radiotherapy plans in treatment of multiple lesions non-small cell lung cancer patients. Iranian Journal of Medical Physics, 20, 146-152. https://doi.org/10.22038/IJMP.2022.57836.2064
[10]Herfarth, K. K., Debus, J., Lohr, F., Bahner, M. L., Fritz, P., Höss, A., Schlegel, W., & Wannenmacher, M. F. (2000). Extracranial stereotactic radiation therapy: Set-up accuracy of patients treated for liver metastases. International Journal of Radiation Oncology Biology Physics, 46(2), 329-335. https://doi.org/10.1016/S0360-3016(99)00413-7 DOI: https://doi.org/10.1016/S0360-3016(99)00413-7
[11]Lax, I., Blomgren, H., Näslund, I., & Svanström, R. (1994). Stereotactic radiotherapy of malignancies in the abdomen: Methodological aspects. Acta Oncologica, 33(6), 677-683. https://doi.org/10.3109/02841869409121782 DOI: https://doi.org/10.3109/02841869409121782
[12]Fakiris, A. J., McGarry, R. C., Yiannoutsos, C. T., et al. (2009). Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: Four-year results of a prospective phase II study. International Journal of Radiation Oncology Biology Physics, 75, 677-682. https://doi.org/10.1016/j.ijrobp.2008.08.070 DOI: https://doi.org/10.1016/j.ijrobp.2008.11.042
[13]International Commission on Radiation Units and Measurements. (2010). Report 83. Journal of the ICRU, 10(1). https://doi.org/10.1093/jicru/ndq001 DOI: https://doi.org/10.1093/jicru/ndq001
[14]Shi, C., Tazi, A., Fang, D. X., & Iannuzzi, C. (2013). Implementation and evaluation of modified dynamic conformal arc (MDCA) technique for lung SBRT patients following RTOG protocols. Medical Dosimetry, 38(3), 287-290. https://doi.org/10.1016/j.meddos.2013.02.010 DOI: https://doi.org/10.1016/j.meddos.2013.02.010
[15]Radiation Therapy Oncology Group. (n.d.). RTOG 0813: Seamless phase I/II study of stereotactic lung radiotherapy (SBRT) for early stage, centrally located, non-small cell lung cancer (NSCLC) in medically inoperable patients. (No DOI available for this protocol)
[16]Clark, C. H., Hurkmans, C. W., Kry, S. F., & The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonisation Group. (2017). The role of dosimetry audit in lung SBRT multi-centre clinical trials. Physica Medica, 44, 171-176. https://doi.org/10.1016/j.ejmp.2017.04.003 DOI: https://doi.org/10.1016/j.ejmp.2017.04.003
[17]Tsang, M. W. K. (2016). Stereotactic body radiotherapy: Current strategies and future development. Journal of Thoracic Disease, 8(4), E304-E306. https://doi.org/10.21037/jtd.2016.03.14 DOI: https://doi.org/10.21037/jtd.2016.03.14
[18]Feuvret, L., Noël, G., Mazeron, J. J., & Bey, P. (2006). Conformity index: A review. International Journal of Radiation Oncology Biology Physics, 64(2), 333-342. https://doi.org/10.1016/j.ijrobp.2005.11.043 DOI: https://doi.org/10.1016/j.ijrobp.2005.09.028
[19]Paddick, I. (2000). A simple scoring ratio to index the conformity of radiosurgical treatment plans. Journal of Neurosurgery, 93(Suppl 3), 219-222. https://doi.org/10.3171/jns.2000.93.3.0219 DOI: https://doi.org/10.3171/jns.2000.93.supplement_3.0219
[20]Shaw, E., Kline, R., Gillin, M., et al. (1993). Radiation Therapy Oncology Group: Radiosurgery quality assurance guidelines. International Journal of Radiation Oncology Biology Physics, 27, 1231-1239. https://doi.org/10.1016/0360-3016(93)90191-5 DOI: https://doi.org/10.1016/0360-3016(93)90548-A
[21]AAPM Task Group No. 218. (2018). Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations. Medical Physics. https://doi.org/10.1002/mp.12810 DOI: https://doi.org/10.1002/mp.12810
[22]Rehman, S., Roach, M. C., Bradley, J. D., et al. (2015). Lung stereotactic body radiation therapy. Science and Medicine in Radiotherapy and Oncology, Missouri Medicine, 112(5), 361-365. (No DOI available)
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