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Report No. 091 - The Management of Respiratory Motion in Radiation Oncology (2006)

Category: Reports

This document is the report of a task group of the American Association of Physicists in Medicine (AAPM) and has been prepared primarily to advise medical physicists involved in the external-beam radiation therapy of patients with thoracic, abdominal, and pelvic tumors affected by respiratory motion. This report describes the magnitude of respiratory motion, discusses radiotherapy-specific problems caused by respiratory motion, explains techniques that explicitly manage respiratory motion during radiotherapy, and gives recommendations in the application of these techniques for patient care, including quality assurance (QA) guidelines for these devices and their use with conformal and intensity-modulated radiotherapy. The technologies covered by this report are motion-encompassing methods, respiratory-gated techniques, breath-hold techniques, forced shallow-breathing methods, and respiration-synchronized techniques. The main outcome of this report is a clinical process guide for managing respiratory motion. Included in this guide is the recommendation that tumor motion should be measured (when possible) for each patient for whom respiratory motion is a concern. If target motion is greater than 5 mm, a method of respiratory motion management is available; and if the patient can tolerate the procedure, respiratory motion management technology is appropriate. Respiratory motion management is also appropriate when the procedure will increase normal tissue sparing. Respiratory motion management involves further resources, education, and the development of and adherence to QA procedures. Knowledge in the field of respiratory motion in radiation oncology is continually growing. This report is intended to reflect the current state of the scientific understanding and technical methodology in imaging, treatment planning, and radiation delivery for radiation oncology patients with tumors affected by respiratory motion.

Medical Physics, 33, 3874-3900 (2006)
http://dx.doi.org/10.1118/1.2349696
ISBN: 978-1-888340-61-7
Radiation Therapy Committee Task Group #76

Paul J. Keall, Gig S. Mageras, James M. Balter, Richard S. Emery, Kenneth M. Forster, Steve B. Jiang, Jeffrey M. Kapatoes, Hideo D. Kubo, Daniel A. Low, Martin J. Murphy, Brad R. Murray, Chester R. Ramsey, Marcel B. van Herk, S. Sastry Vedam, John W. Wong, Ellen Yorke

Committee Responsible: Treatment Delivery Subcommittee
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