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Please use this identifier to cite or link to this item: http://hdl.handle.net/10271/3204

Title: Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation
Other Titles: 原発性肺癌に対する肺葉特異性選択的予防的リンパ節領域照射を加えた体幹部定位照射の実現可能性に関する放射線量的評価
Authors: Komatsu, Tetsuya
小松, 哲也
Keywords: stereotactic body radiotherapy
elective nodal irradiation
primary lung cancer
dose–volume histogram
Issue Date: Jan-2016
Publisher: Japan Radiation Research Society
Abstract: More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose–volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V 20 of the lung, D 1cm 3 of the spinal cord, D 1cm 3 and D 10cm 3 of the esophagus and D 10cm 3 of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible.
Description: 浜松医科大学学位論文 医博論第529号(平成28年9月16日)
URI: http://hdl.handle.net/10271/3204
DOI: info:doi/10.1093/jrr/rrv067
PubMed ID: info:pmid/26566656
Academic Degrees and number: 13802乙第529号
Degree-granting date: 2016-09-16
Degree name: 博士(医学)
Degree-granting institutions: 浜松医科大学
Appears in Collections:2010 博士(論文)

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