1. Four-dimensional computed tomography-based respiratory-gated whole-abdominal intensity-modulated radiation therapy for ovarian cancer: a feasibility study
- Author
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E Brandner, M.S. Huq, Dwight E. Heron, Andrew Wu, H Chen, Adam A. Garsa, J. N. Yue, Kristina Gerszten, Hyun Soo Kim, G. Kuo, J. Lee, R.S. Andrade, Sushil Beriwal, and R. Lalonde
- Subjects
medicine.medical_specialty ,Nausea ,Anemia ,medicine.medical_treatment ,medicine ,Humans ,Respiratory system ,Neoplasm Staging ,Ovarian Neoplasms ,Leukopenia ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Respiration ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,Toxicity ,Feasibility Studies ,Female ,Radiotherapy, Intensity-Modulated ,Radiology ,Bone marrow ,medicine.symptom ,Tomography, X-Ray Computed ,Ovarian cancer ,business - Abstract
This study assesses the feasibility and implementation of respiratory-gated whole-abdominal intensity-modulated radiation therapy (RG-WAIMRT). Three patients were treated with RG-WAIMRT. The planning target volume (PTV1) included the entire peritoneal cavity and a pelvic boost field was created (PTV2). The dose prescribed was 30 Gy to PTV1 and 14.4 Gy to PTV2. For comparison, a conventional three-dimensional (3D) plan was generated for each patient. In the WAIMRT plan, an average of 90% of PTV1 received 30 Gy compared to 70% for the conventional 3D plan. The percent volume receiving 30 Gy (V30) for liver averaged 54% (WAIMRT) vs 43% (3D). The percent volume receiving 20 Gy (V20) for kidneys averaged 19% vs 0%, and the mean V20 for bone marrow was 74% vs 83%, respectively. Major acute toxicities were anemia (grade 2: 1/3), leukopenia (grade 3: 2/3 patients), and thrombocytopenia (grade 2: 1/3 patients, grade 3: 1/3 patients). One patient could not complete the whole-abdomen field after 19.5 Gy because of persistent nausea. No major subacute toxicity has been reported. WAIMRT demonstrated superior target coverage and reduced dose to bone marrow, with a slightly increased dose to liver and kidneys. WAIMRT is a novel and feasible technique for ovarian cancer treatment.
- Published
- 2007
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