The clinical implementation of respiratory-gated intensity-modulated radiotherapy.

The clinical implementation of respiratory-gated intensity-modulated radiotherapy. Research Abstract Details 

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The clinical implementation of respiratory-gated intensity-modulated radiotherapy. Abstract Text:

Paul Keall,Sastry Vedam,Rohini George,Chris Bartee,Jeffrey Siebers,Fritz Lerma,Elisabeth Weiss,Theodore Chung,

The clinical use of respiratory-gated radiotherapy and the application of intensity-modulated radiotherapy (IMRT) are 2 relatively new innovations to the treatment of lung cancer. Respiratory gating can reduce the deleterious effects of intrafraction motion, and IMRT can concurrently increase tumor dose homogeneity and reduce dose to critical structures including the lungs, spinal cord, esophagus, and heart. The aim of this work is to describe the clinical implementation of respiratory-gated IMRT for the treatment of non-small cell lung cancer. Documented clinical procedures were developed to include a tumor motion study, gated CT imaging, IMRT treatment planning, and gated IMRT delivery. Treatment planning procedures for respiratory-gated IMRT including beam arrangements and dose-volume constraints were developed. Quality assurance procedures were designed to quantify both the dosimetric and positional accuracy of respiratory-gated IMRT, including film dosimetry dose measurements and Monte Carlo dose calculations for verification and validation of individual patient treatments. Respiratory-gated IMRT is accepted by both treatment staff and patients. The dosimetric and positional quality assurance test results indicate that respiratory-gated IMRT can be delivered accurately. If carefully implemented, respiratory-gated IMRT is a practical alternative to conventional thoracic radiotherapy. For mobile tumors, respiratory-gated radiotherapy is used as the standard of care at our institution. Due to the increased workload, the choice of IMRT is taken on a case-by-case basis, with approximately half of the non-small cell lung cancer patients receiving respiratory-gated IMRT. We are currently evaluating whether superior tumor coverage and limited normal tissue dosing will lead to improvements in local control and survival in non-small cell lung cancer.

The clinical implementation of respiratory-gated intensity-modulated radiotherapy. Publishing Authors By Initials

P Keall,S Vedam,R George,C Bartee,J Siebers,F Lerma,E Weiss,T Chung,

For similar circulatory and respiratory physiology: respiratory physiology: respiratory physiologic processes: respiration: respiratory mechanics research abstracts see: circulatory and respiratory physiology: respiratory physiology: respiratory physiologic processes: respiration: respiratory mechanics research

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The clinical implementation of respiratory-gated intensity-modulated radiotherapy. Journal Published:

PUBLICATION TYPE: Review

Journal: Medical dosimetry : official journal of the Americ

VOLUME: 31

Page Numbers: 152-62

Journal Abbreviation:

ISSN: 0958-3947

DAY: 3

MONTH: 12

YEAR: 2006

The clinical implementation of respiratory-gated intensity-modulated radiotherapy. Information

Number of References: 73

LANGUAGE: eng

NlmUniqueID: 8908862

The clinical implementation of respiratory-gated intensity-modulated radiotherapy. Keywords Mesh Terms:

KEYWORDS: Respiratory Mechanics

MESH TERMS: methods

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Grant and Affiliation Information for The clinical implementation of respiratory-gated intensity-modulated radiotherapy.

AFFILIATION: Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA 23298, USA. pjkeall@vcu.edu

Country: United States

AGENCY: United States PHS

GRANT: R01 93626

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MEDLINETA: Med Dosim

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