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The Dosimetric and Temporal Effects of Respiratory-Gated Radiation Therapy in Lung Cancer Patients

J Xia

O Rouabhi1 , B Gross1 , J Bayouth2 , J Xia1*, (1) University of Iowa, Iowa City, Iowa, (2) University of Wisconsin, Madison, WI


SU-E-J-169 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: To evaluate the dosimetric and temporal effects of high dose rate treatment mode for respiratory-gated radiation therapy in lung cancer patients.

Methods: Treatment plans from five lung cancer patients (3 non-gated (Group 1), 2 gated at 80EX-80IN (Group 2)) were retrospectively evaluated. The maximum tumor motions range from 6 - 12 mm. Using the same planning criteria, four new treatment plans, corresponding to four gating windows (20EX-20IN, 40EX-40IN, 60EX-60IN, and 80EX-80IN), were generated for each patient. Mean tumor dose (MTD), mean lung dose (MLD), and lung V20 were used to assess the dosimetric effects. A MATLAB algorithm was developed to compute treatment time by considering gantry rotation time, time to position collimator leaves, dose delivery time (scaled relative to the gating window), and communication overhead. Treatment delivery time for each plan was estimated using a 500 MU/min dose rate for the original plans and a 1500 MU/min dose rate for the gated plans.

Results: Differences in MTD were less than 1Gy across plans for all five patients. MLD and lung V20 were on average reduced between -16.1% to -6.0% and -20.0% to -7.2%, respectively for non-gated plans when compared with the corresponding gated plans, and between -5.8% to -4.2% and -7.0% to -5.4%, respectively for plans originally gated at 80EX-80IN when compared with the corresponding 20EX-20IN to 60EX-60IN gated plans. Treatment delivery times of gated plans using high dose rate were reduced on average between -19.7% (-1.9min) to -27.2% (-2.7min) for originally non-gated plans and -15.6% (-0.9min) to -20.3% (-1.2min) for originally 80EX-80IN gated plans.

Conclusion: Respiratory-gated radiation therapy in lung cancer patients can reduce lung toxicity, while maintaining tumor dose. Using a gated high-dose-rate treatment, delivery time comparable to non-gated normal-dose-rate treatment can be achieved.

Funding Support, Disclosures, and Conflict of Interest: This research is supported by Siemens Medical Solutions USA, Inc

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