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- W1988757135 abstract "Targets for radiation therapy (RT) of lung cancer may include multiple lesions and/or involved nodal regions in the same treatment course. Any interfraction relative volume changes and/or independent motions between these targets will not be fully accounted for by the current IGRT repositioning practice or offline adaptive replanning. This work is to quantify these interfraction variations so that appropriate online adaptive RT can be developed. Daily CT data acquired for ten lung cancer patients treated with IGRT using an in-room CT along with their planning 4DCT data were analyzed retrospectively. On each daily CT set, contours of the targets [gross tumor volume (GTV), clinical tumor volumes (CTV), involved nodal regions] and organs at risk (OARs), including cord, esophagus, heart, and lungs, were generated by populating the planning contours using an auto-segmentation tool based on deformable registration with manual editing. Daily relative motion between the targets was measured by the deviation of the displacement of their centers of masses (DCOM) on daily CT from that on the planning CT. Non-zero deviations indicate that there exist independent motions between the targets. The relative volume change of different targets was measured by the ratio of their daily volumes normalized to that of the plan. A constant ratio implies that targets’ volumes vary at the same speed during treatment. The impact of respiration motion was considered by using the breathing motion information from the planning CT. For the patients studied, the daily targets’ volumes vary in the range of 120%-60% from their planning volumes, with an average of 86 ± 17% (one standard deviation). Two patients were found to have different tumor and nodal volume changing speed, one with the daily tumor volume increased by up to 120% in the first two weeks of treatment and decreased to 80% in the remaining 4-weeks treatment at the similar speed of the nodal volume shrinking during the entire treatment; the other with 30% nodal volume shrinking but no obvious tumor volume shrinking in the 6-week treatment. Tumor and nodal volumes’ shrinking at similar speed were found for other patients. The daily deviations of DCOM from the plans vary from −10 to 8 mm with an average −0.7 ± 3.4 mm. No correlations between the tumor and nodal volume variations and their DCOM variations were observed as expected given random features of these variations. There exist considerable interfraction relative volume changes and independent motions between multiple targets during radiation therapy for lung cancer. These interfraction variations are generally complex and unpredictable, indicating that appropriate online adaptive strategies may be beneficial for this patient population." @default.
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- W1988757135 date "2013-10-01" @default.
- W1988757135 modified "2023-09-27" @default.
- W1988757135 title "Interfraction Relative Volume Changes and Independent Motions Between Multiple Targets in Lung Cancer Radiation Therapy" @default.
- W1988757135 doi "https://doi.org/10.1016/j.ijrobp.2013.06.1894" @default.
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