A phase 2 trial of deep-inspiration breath hold in radiotherapy of gastric lymphomas.
Deep inspiration breath-hold
Gastric lymphoma
Motion management
Journal
Physics and imaging in radiation oncology
ISSN: 2405-6316
Titre abrégé: Phys Imaging Radiat Oncol
Pays: Netherlands
ID NLM: 101704276
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
30
09
2021
revised:
09
05
2022
accepted:
12
05
2022
entrez:
22
7
2022
pubmed:
23
7
2022
medline:
23
7
2022
Statut:
epublish
Résumé
Radiotherapy (RT) is an important part in the treatment of gastric lymphomas and the prognosis after radiotherapy is very good with a good chance of long-term survival, so prevention of long-term adverse effects is important. In patients with gastric lymphomas cardiac late effects are of most concern. The aim of this study was to assess if the dose to the heart could be reduced with deep inspiration breath-hold (DIBH) without compromising the dose to the target or increasing the risk of other late effects. Fifteen patients with gastric lymphoma were included. RT plans were made using DIBH and Free breathing (FB) scans. Clinical target volume (CTV) was the stomach plus 1 cm margin. The heart and surrounding organs at risk (OAR) were contoured. Two sets of plan comparisons were made, one with 1 cm CTV to planning target volume (PTV) margin in both DIBH and FB and one set with an additional 5 mm CTV to PTV margin in cranio-caudal direction with FB. Datasets were analysed with Wilcoxon signed rank test for non-parametric paired data. All patients tolerated the procedures and were treated with volumetric arc therapy technique in DIBH. Target coverage was kept equal between FB and DIBH, while a statistically significant reduction of the estimated does to the heart was seen with DIBH. Median mean heart dose was reduced from 7.1 Gy (5.7-12) to a median of 3.2 Gy (1.2-7.0) and heart V20 from a median of 54 (17-106) cm This clinical trial of RT with DIBH for gastric lymphomas showed that the heart dose could be reduced without compromising PTV coverage. The doses to abdominal OARs were similar with FB and DIBH.
Sections du résumé
Background and purpose
UNASSIGNED
Radiotherapy (RT) is an important part in the treatment of gastric lymphomas and the prognosis after radiotherapy is very good with a good chance of long-term survival, so prevention of long-term adverse effects is important. In patients with gastric lymphomas cardiac late effects are of most concern. The aim of this study was to assess if the dose to the heart could be reduced with deep inspiration breath-hold (DIBH) without compromising the dose to the target or increasing the risk of other late effects.
Methods and patients
UNASSIGNED
Fifteen patients with gastric lymphoma were included. RT plans were made using DIBH and Free breathing (FB) scans. Clinical target volume (CTV) was the stomach plus 1 cm margin. The heart and surrounding organs at risk (OAR) were contoured. Two sets of plan comparisons were made, one with 1 cm CTV to planning target volume (PTV) margin in both DIBH and FB and one set with an additional 5 mm CTV to PTV margin in cranio-caudal direction with FB. Datasets were analysed with Wilcoxon signed rank test for non-parametric paired data.
Results
UNASSIGNED
All patients tolerated the procedures and were treated with volumetric arc therapy technique in DIBH. Target coverage was kept equal between FB and DIBH, while a statistically significant reduction of the estimated does to the heart was seen with DIBH. Median mean heart dose was reduced from 7.1 Gy (5.7-12) to a median of 3.2 Gy (1.2-7.0) and heart V20 from a median of 54 (17-106) cm
Conclusion
UNASSIGNED
This clinical trial of RT with DIBH for gastric lymphomas showed that the heart dose could be reduced without compromising PTV coverage. The doses to abdominal OARs were similar with FB and DIBH.
Identifiants
pubmed: 35865617
doi: 10.1016/j.phro.2022.05.008
pii: S2405-6316(22)00048-3
pmc: PMC9295184
doi:
Types de publication
Journal Article
Langues
eng
Pagination
137-141Informations de copyright
© 2022 Published by Elsevier B.V. on behalf of European Society of Radiotherapy & Oncology.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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