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Minimal benefit of respiratory‐gated radiation therapy in the management of thoracic malignancy
Author(s) -
Hau Eric,
Rains Melissa,
Browne Lois,
Muirhead Rebecca,
YeghiaianAlvandi Roland
Publication year - 2013
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12088
Subject(s) - medicine , radiation therapy , malignancy , lung , nuclear medicine , radiology , breathing , lung volumes , respiratory system , anesthesia
Background Respiratory‐gated radiotherapy ( RGRT ) is used in several centres around the world. However, there is continuing controversy regarding the benefit of this technique. The aims of this study are to quantify the dosimetric benefits and the potential predictive factors. Methods Thirty‐four consecutive patients were planned using the RGRT and the F ree B reathing ( FB ) approach and compared with regard to target volume coverage and normal tissue parameters. Potential predictive factors were also evaluated. Results Tumour coverage was similar 94.4% versus 95.5%. Use of RGRT was not associated with a significant reduction in spinal cord, oesophagus or cardiac dosimetric parameters. However, it did reduce the lung mean dose by 1.33 Gy ( P < 0.001) and V20 by 2.2% ( P < 0.001). Only superior/inferior displacement of >1 cm was predictive of a >5% reduction in lung V 20 parameter, and these patients all had a gross tumour volume ( GTV ) of <100 cm 3 . Conclusions The dosimetric benefit of applying RGRT is small when applied in an unselected population of patients. Superior/inferior displacement of >1 cm for tumours with GTV less than 100 cm 3 may be used to select patients who may derive a >5% reduction in lung V 20 parameters.