[an error occurred while processing this directive] | [an error occurred while processing this directive]
To study the feasibility of contouring the planning organ at risk volume for heart based on kilovolt cone-beam CT images
LIU Cheng-xin, GONG Guan-zhong, LI Bao-sheng, WANG Zhong-tang, LU Jie, LIU Tong-hai, LI Hong-sheng, YIN Yong.
Department of Radiation Oncology, Shandong Cancer Hospital;School of Medicine and Life Sciences, Ji′nan University and Shandong Academy of Medical Sciences, Ji′nan 250117, China
Objective To study the feasibility of contouring heart planning organ at risk volume (PRV) on kilovolt cone-beam CT (CBCT) images, and measure the margins for the PRV of heart based on planning CT images. Methods 15 early stage non-small cell lung cancer (NSCLC) patients accepted radiotherapy in our hospital were selected. For every case, CBCT scan was achieved before every fraction to correct the setup error, and the first 10 serious CBCT images were selected in present research. After contouring the heart on CBCT images according to the same standard, compared the differences of heart between CT and CBCT, analyzed the reproducibility of contouring the heart on different serious CBCT images, measured the margins in different axial direction from heart on planning CT to CBCT. Results The heart volume of planning CT was smaller than CBCTs with statistical difference (588 cm3 vs.717 cm3,P=0.000). The volumes based on different serious CBCT images were similar for every patient (P=0.999) and the coincidence of the hearts region on the same anatomical section between the first serious CBCT and others serious could reach to 0.985±0.020 without statistical significant difference (P=0.070). The mean margins for heart from planning CT to CBCT was (10.5 ± 2.8) mm,(5.9 ± 2.8) mm,(2.2 ± 1.6) mm,(3.3 ± 2.2) mm,(6.7 ± 1.1) mm and (4.5 ± 2.5) mm in the left, right, anterior and posterior direction;respectively. Conclusions The PRV of heart contouring based on CBCT was feasible. If there were no CBCT, 11 mm in left direction, 6 mm in right direction, 3 mm in head-foot direction, 7 mm in the anterior direction, and 5 mm in posterior direction should be applied to obtain the PRV of heart.
LIU Cheng-xin,GONG Guan-zhong,LI Bao-sheng et al. To study the feasibility of contouring the planning organ at risk volume for heart based on kilovolt cone-beam CT images[J]. Chinese Journal of Radiation Oncology, 2013, 22(5): 405-407.
LIU Cheng-xin,GONG Guan-zhong,LI Bao-sheng et al. To study the feasibility of contouring the planning organ at risk volume for heart based on kilovolt cone-beam CT images[J]. Chinese Journal of Radiation Oncology, 2013, 22(5): 405-407.
[1]Sampson MC, Katz A, Constine LS, et al. Stereotactic body radiation therapy for extracranial oligometastases:does the sword have a double edge? Semin Radiat Oncol,2006,16:67-76. [2]Yu R, Li YH, Zhu GY, et al. Stereotactic body radiation therapy for 15 patients with small lung neoplasms. Chin J Lung Cancer,2011,14:266-270. [3]Hardenbergh PH, Munley MT, Bentel GC, et al. Cardiac perfusion changes in patients treated for breast cancer with radiation therapy and doxorubicin:preliminary results, Int J Radiat Oncol Biol Phys,2001,49:1023-1028. [4]Yu X, Zhou S, Kahn D, et al. Persistence of radiation (RT)-induced cardiac perfusion defects 3-5 years post RT. J Clin Oncol,2004,22(14 Suppl):33. [5]于金明.放射治疗在肿瘤治疗中的地位//于金明,殷蔚伯,李宝生.肿瘤精确放射治疗学.济南:山东科学技术出版,2003:3-12. [6]陈慧娟,钟军,王索宇,等.ABC对肺肿瘤运动和放疗靶区及肺受照射剂量的影响.实用癌症杂志,2010,25:53-56. [7]Carmel RJ, Kaplan HS. Mantle irradiation in Hodgkin′s disease. An analysis of technique, tumor eradication, and complications. Cancer,1976,37:2813-2825. [8]Adams MJ, Lipsitz SR, Colan SD, et al. Cardiovascular status in long-term survivors of Hodgkin′s disease treated with chest radiotherapy. J Clin Oncol,2004,22:3139-3148. [9]Harris EE, Correa C, Hwang WT, et al. Late cardiac mortality and morbidity in early-stage breast cancer patients after breast conservation treatment. J Clin Oncol,2006,24:4100-4106. [10]Hooning MJ, Botma A, Aleman BM, et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst,2007,99:365-375. [11]Glanzmann C, Huguenin P, Lutolf UM, et al. Cardiac lesions after mediastinal irradiation for Hodgkin′s disease. Radiother Oncol,1994,30:43-54. [12]Lund MB, Ihlen H, Voss BM, et al. Increased risk of heart valve regurgitation after mediastinal radiation for Hodgkin′s disease:an echocardiographic study. Heart,1996,75:591-595. [13]Early Breast Cancer Trialists′ Collaborative Group. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival:an overview of the randomized trials. Lancet,2005,366:2087-2106. [14]Marks LB, Yu X, Prosnitz RG, et al. Functional consequences of radiation (RT)-induced perfusion changes in patients with left-sided breast cancer. Int J Radiat Oncol Biol Phys,2002,54(2 Suppl):s3-4. [15]Aleman BM, Belt-Dusebout AW, Klokman WJ, et al. Long-term cause-specific mortality of patients treated for Hodgkin′s disease. J Clin Oncol,2003,21:3431-3439. [16]Hooning MJ, Aleman BMP, van Rosmalen AJM,et al. Cause-specific mortality in long-term survivors of breast cancer, a 25-year follow-up study. Int J Radiat Oncol Biol Phys,2006,64:1081-1091. [17]Gagliardi G, Constine LS, Moiseenko V, et al. Radiation dose-volume effects in the heart. Int J Radiat Oncol Biol Phys,2010,76(3 Suppl):s77-85. [18]Marks LB, Yu X, Prosnitz RG, et al. The incidence and functional consequences of RT-associated cardiac perfusion defects Int J Radiat Oncol Biol Phys,2005,63:214-223. [19]Boivin JF, Hutchison GB, Lubin JH, et al. Coronary artery disease mortality in patients treated for Hodgkin′s disease. Cancer,1992,69:1241-1247. [20]Hancock SL, Donaldsson SS, Hoppe RT. Cardiac disease following treatment of Hodgkin′s disease in children and adolescents. J Clin Oncol,1993,11:1208-1215. [21]Plowman PN. Radiotherapy considerations in patients with Hodgkin′s disease who receive mediastinal radiotherapy and anthracycline-containing chemotherapy. Clin Oncol,1998,10:384-391. [22]Hancock SL, Tucker MA, Hoppe RT. Factors affecting late mortality from heart disease after treatment of Hodkgin′s disease. J Am Med Assoc,1993,270:1949-1955. [23]Topolnjak R, Borst GR, Nijkamp J, et al. Image-guided Radiotherapy for left-sided breast cancer patients:geometrical uncertainty of the heart. Int J Radiat Oncol Biol Phys,2012,83:647-655.