Potential morbidity reduction for lung stereotactic body radiation therapy using respiratory gating

Kraus KM, Simonetto C, Kundrat P, Waitz V, Borm KJ, Combs SE (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Cancers MDPI

Book Volume: 13

Article Number: 5092

Journal Issue: 20

DOI: 10.3390/cancers13205092

Abstract

We investigated the potential of respiratory gating to mitigate the motion-caused misdos-age in lung stereotactic body radiotherapy (SBRT). For fourteen patients with lung tumors, we investigated treatment plans for a gating window (GW) including three breathing phases around the maximum exhalation phase, GW40-60. For a subset of six patients, we also assessed a preceding three-phase GW20-40 and six-phase GW20-70. We analyzed the target volume, lung, esophagus, and heart doses. Using normal tissue complication probability (NTCP) models, we estimated radiation pneumonitis and esophagitis risks. Compared to plans without gating, GW40-60 significantly reduced doses to organs at risk without impairing the tumor doses. On average, the mean lung dose decreased by 0.6 Gy (p < 0.001), treated lung V20Gy by 2.4% (p = 0.003), esophageal dose to 5cc by 2.0 Gy (p = 0.003), and maximum heart dose by 3.2 Gy (p = 0.009). The model-estimated mean risks of 11% for pneumonitis and 12% for esophagitis without gating decreased upon GW40-60 to 7% and 9%, respectively. For the highest-risk patient, gating reduced the pneumonitis risk from 43% to 32%. Gating is most beneficial for patients with high-toxicity risks. Pre-treatment toxicity risk assessment may help optimize patient selection for gating, as well as GW selection for individual patients.

Involved external institutions

Technische Universität München (TUM) DE Germany (DE) Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (HMGU) / Helmholtz Munich DE Germany (DE) Academy of Sciences of the Czech Republic (ASCR) / Akademie věd České republiky (AVČR) CZ Czech Republic (CZ)

How to cite

APA:

Kraus, K.M., Simonetto, C., Kundrat, P., Waitz, V., Borm, K.J., & Combs, S.E. (2021). Potential morbidity reduction for lung stereotactic body radiation therapy using respiratory gating. Cancers, 13(20). https://doi.org/10.3390/cancers13205092

MLA:

Kraus, Kim Melanie, et al. "Potential morbidity reduction for lung stereotactic body radiation therapy using respiratory gating." Cancers 13.20 (2021).

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