Optimizing target and diaphragmatic configuration, and dosimetric benefits using continuous positive airway pressure in stereotactic ablative radiotherapy for lung tumors

• 발행기관: 대한방사선종양학회
• 저자명: Jung Bin Park Joo Ho Lee Ji Hyun Chang Jaeman Son Seho Kwon Su Yun Choi Hyun-Woo Shin Tosol Yu Hak Jae Kim
• 간행물 정보: 『대한방사선종양학회지』제42권 제3호, 200~209쪽, 전체 10쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2024.09.30

국문 초록

Purpose: This study aimed to evaluate the impact of facilitating target delineation of continuous positive airway pressure (CPAP) in patients undergoing stereotactic ablative radiation therapy (SABR) for lung tumors by lung expansion and respiratory motion management. Materials and Methods: We performed a prospective single-institutional trial of patients who were diagnosed with either primary lung cancer or lung metastases and received SABR with a dose of 40 to 60 Gy in 4 fractions. Four-dimensional computed tomography simulations were conducted for each patient: once without CPAP and again with CPAP. Results: Thirty-two patients with 39 tumors were analyzed, after the withdrawal of five patients due to discomfort. For 26 tumors separated from the diaphragm, CPAP significantly increased the superoinferior distance between the tumor and the diaphragm (5.96 cm vs. 8.06 cm; p < 0.001). For 13 tumors located adjacent to the diaphragm, CPAP decreased the overlap of planning target volume (PTV) with the diaphragm significantly (6.32 cm3 vs. 4.09 cm3; p = 0.002). PTV showed a significant reduction with CPAP (25.06 cm3 vs. 22.52 cm3, p = 0.017). In dosimetric analyses, CPAP expanded lung volume by 58.4% with a significant reduction in mean dose and V5 to V40. No more than grade 2 adverse events were reported. Conclusion: This trial demonstrated significant improvement of CPAP in target delineation uncertainties for lung SABR, with dosimetric benefits, a favorable safety profile and tolerability. Further investigation is warranted to explore the role of CPAP as a novel strategy for respiratory motion management.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Funding

Author Contributions

Data Availability Statement

References

키워드

Stereotactic body radiotherapy Radiotherapy Respiratory-gated imaging techniques Lung neoplasms Continuous positive airway pressure Image segmentation