Abstract
Tremendous technological progress in the field of imaging and computation have been revolutionizing radiotherapy of non-small cell lung cancer (NSCLC). Tumor biology can now be characterized by functional imaging for modifying treatment management and dose delivered in better accordance with the radiobiology of solid tumors and normal tissues. Specific radiation therapy (RT) strategies can further address the tumor motion issue, ensuring optimal tumor coverage with small safety margins.
Highlights
Treatment planning strategiesThe respiratory synchronized techniques that intend to either gate the dose delivery at a certain tumor position or track the tumor in real-time are appealing since they minimize the tumor motion contribution in the safety margin calculation [26,27,28,29]
Radiation therapy has been long unacceptable short- and long-term past recognized as one of the main toxicities when dose intensification treatment modalities of locally- is considered
The be achieved in new high precision cell lung cancer (NSCLC) radiation therapy (RT) without improved survival of stage III NSCLC optimally accounting for respiratorypatients with the concurrent delivery correlated tumor motion
Summary
The respiratory synchronized techniques that intend to either gate the dose delivery at a certain tumor position or track the tumor in real-time are appealing since they minimize the tumor motion contribution in the safety margin calculation [26,27,28,29]. A 3D image only represents a snapshot of the tumor motion, from which the tumor position can significantly and systematically diverge from its mean position over the whole breathing cycle Removing this systematic error allows a substantial reduction of the safety margins, compared to conventional 3D CT and ITV strategies, margins that are close to those obtained with gated radiotherapy. A complete, unique validation of this approach with tomotherapy treatment is on going in our lab, which addresses volumetric, dosimetric and dose delivery aspects with Monte Carlo calculation verification [32]
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