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Ayadi M, Baudier T, Bouilhol G, Dupuis P, Boissard P, Pinho R, Krason A, Rit S, Claude L, Sarrut D. Mid-position treatment strategy for locally advanced lung cancer: a dosimetric study. Br J Radiol 2020; 93:20190692. [PMID: 32293191 PMCID: PMC10993224 DOI: 10.1259/bjr.20190692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The internal target volume (ITV) strategy generates larger planning target volumes (PTVs) in locally advanced non-small cell lung cancer (LA-NSCLC) than the Mid-position (Mid-p) strategy. We investigated the benefit of the Mid-p strategy regarding PTV reduction and dose to the organs at risk (OARs). METHODS 44 patients with LA-NSCLC were included in a randomized clinical study to compare ITV and Mid-p strategies. GTV were delineated by a physician on maximum intensity projection images and on Mid-p images from four-dimensional CTs. CTVs were obtained by adding 6 mm uniform margin for microscopic extension. CTV to PTV margins were calculated using the van Herk's recipe for setup and delineation errors. For the Mid-p strategy, the mean target motion amplitude was added as a random error. For both strategies, three-dimensional conformal plans delivering 60-66 Gy to PTV were performed. PTVs, dose-volume parameters for OARs (lung, esophagus, heart, spinal cord) were reported and compared. RESULTS With the Mid-p strategy, the median of volume reduction was 23.5 cm3 (p = 0.012) and 8.8 cm3 (p = 0.0083) for PTVT and PTVN respectively; the median mean lung dose reduction was 0.51 Gy (p = 0.0057). For 37.1% of the patients, delineation errors led to smaller PTV with the ITV strategy than with the Mid-p strategy. CONCLUSION PTV and mean lung dose were significantly reduced using the Mid-p strategy. Delineation uncertainty can unfavorably impact the advantage. ADVANCES IN KNOWLEDGE To the best of our knowledge, this is the first dosimetric comparison study between ITV and Mid-p strategies for LA-NSCLC.
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Affiliation(s)
- M. Ayadi
- Radiotherapy and Physics Department, Leon Berard Cancer Center,
28, rue Laennec F-69373, Lyon,
France
| | - T. Baudier
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm,
Centre Léon Bérard, CREATIS UMR 5220, U1206,
F-69373, Lyon,
France
| | - G. Bouilhol
- Department of Radiotherapy, Hartmann Radiotherapy Center,
American Hospital of Paris,
Neuilly, France
| | - P. Dupuis
- Radiotherapy and Physics Department, Leon Berard Cancer Center,
28, rue Laennec F-69373, Lyon,
France
| | - P. Boissard
- Radiotherapy and Physics Department, Leon Berard Cancer Center,
28, rue Laennec F-69373, Lyon,
France
| | - R. Pinho
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm,
Centre Léon Bérard, CREATIS UMR 5220, U1206,
F-69373, Lyon,
France
| | - A. Krason
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm,
Centre Léon Bérard, CREATIS UMR 5220, U1206,
F-69373, Lyon,
France
| | - S. Rit
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm,
Centre Léon Bérard, CREATIS UMR 5220, U1206,
F-69373, Lyon,
France
| | - L. Claude
- Radiotherapy and Physics Department, Leon Berard Cancer Center,
28, rue Laennec F-69373, Lyon,
France
| | - D. Sarrut
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm,
Centre Léon Bérard, CREATIS UMR 5220, U1206,
F-69373, Lyon,
France
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Scher N, Bollet M, Lamallem H, Bauduceau O, Bouilhol G, Foster D, Toledano A. Tolérance et efficacité de l’implantation et du suivi de marqueurs fiduciels en radiothérapie stéréotaxique robotisée extracrânienne. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zahra N, Monnet C, Bartha E, Bouilhol G, Boydev C, Courbis M, Le Grévellec M, Bosset M, Zouai M, Fleury B, Clippe S. [Interobserver variability study for daily cone beam computed tomography registration of prostate volumetric modulated arc therapy]. Cancer Radiother 2015. [PMID: 26206733 DOI: 10.1016/j.canrad.2015.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This work evaluated the interobserver variability in cone beam computed tomography (CBCT) registration for prostate cancers treated with intensity-modulated radiotherapy. MATERIAL AND METHODS Twelve technologists realized 286 CBCT/CT registrations (bone registration followed by prostate to prostate registration). The registration results were compared to those obtained by two radiation oncologists (reference). Each technologist reported the shifts calculated by the software in all three axes. A statistical analysis allowed us to calculate the minimum threshold under which 95% of the observers found similar values. A variance analysis followed by the post hoc test were used to find differences in interobserver registration variability and determine whether any individual users performed registrations which differed significantly from those of the other users. RESULTS The registration differences compared to the reference in the three directions in terms of 95th percentile are: 2.1mm left-right, 3.5mm target-gun, 7.3mm anterior-posterior. In the posterior direction, 4% of the observers have found differences superior to 8mm, margin used in routine without the use of a daily CBCT. The variance test revealed a P-value <0.05 only for target-gun and for all observers there was no significant difference compared to the reference. CONCLUSION This study confirmed the interest of a 3D tissue registration for prostate treatments. The registration study showed a good interobserver reproducibility. This showed the importance of a daily CBCT/CT registration in prostate treatment with the possibility of a planning target volume margin reduction in the three directions. An evaluation of a partial delegation of registration to technologists should be done by the radiation oncologists.
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Affiliation(s)
- N Zahra
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France.
| | - C Monnet
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - E Bartha
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - G Bouilhol
- Institut Curie, hôpital René-Huguenin, 35, rue Dailly, 92210 Saint-Cloud, France
| | - C Boydev
- Laboratoire de traitement des signaux 5 (LTS5), école polytechnique fédérale de Lausanne (EPFL), EPFL-STI-IEL-LTS5 Station 11, 1015 Lausanne, Suisse
| | - M Courbis
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - M Le Grévellec
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - M Bosset
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - M Zouai
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - B Fleury
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
| | - S Clippe
- Centre de radiothérapie Marie-Curie, 159, boulevard Maréchal-Juin, 26000 Valence, France
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Ayadi M, Zahra N, Thariat J, Bouilhol G, Boissard P, Van Houtte P, Claude L, Mornex F. Radiothérapie conformationnelle avec modulation d’intensité dans les carcinomes bronchiques non à petites cellules. Cancer Radiother 2014; 18:406-13. [DOI: 10.1016/j.canrad.2014.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 06/24/2014] [Accepted: 06/29/2014] [Indexed: 12/25/2022]
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Sarrut D, Vandemeulebroucke J, Bouilhol G, Pinho R, Delmon V, Rit S. SP-0536: Open source tools for validation of deformable registration. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bouilhol G, Benoit C, Hoog C, Pothier G, Gaumier A, Ayadi M. Determination of an oesophagus PRV for the treatments with cyberknife. Phys Med 2013. [DOI: 10.1016/j.ejmp.2013.08.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Rit S, Pinho R, Bouilhol G, Ayadi M, Biston M, Claude L, Sarrut D. PO-0795 PHASE II CLINICAL TRIAL COMPARING MID-POSITION WITH INTERNAL TARGET VOLUME TREATMENT PLANNING. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bouilhol G, Rit S, Ayadi M, Sarrut D. OC-0393 MARGIN CALCULATION FOR TEMPORALLY ASYMMETRIC RESPIRATORY MOTION. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70732-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ayadi M, Bouilhol G, Imbert L, Ginestet C, Sarrut D. [Scan acquisition parameter optimization for the treatment of moving tumors in radiotherapy]. Cancer Radiother 2010; 15:115-22. [PMID: 21112229 DOI: 10.1016/j.canrad.2010.07.635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 06/18/2010] [Accepted: 07/04/2010] [Indexed: 12/25/2022]
Abstract
AIM OF THE STUDY In the case of lung tumor treatment, to adjust 3D helical computed tomography (CT) acquisition parameters using a dynamic phantom and compare to the theory the volumes of a moving object. MATERIALS AND METHODS Three helical CT acquisitions were compared using a Big Bore CT scan : an "initial" 3D CT scan (constructor parameters), an "optimized" 3D CT scan which parameters are chosen to obtain an axial slow scan like acquisition and a 4D CT scan. We used a phantom composed by a ball filled with water set on a dynamic platform moving in the antero-posterior or cranio-caudal direction with a 14 mm amplitude and a 4s period. For each acquisition and modality (static and dynamic), we quantified the ball volume by automatic contouring and we estimated relative errors. RESULTS For an antero-posterior displacement, the volume of the moving ball is under estimated by 14.1 % with the "initial" scan, by 0.2 % with the "optimized" scan and over estimated by 0.8 % with the averaged 4D scan. For a cranio-caudal displacement, it is under estimated by about 22 % with the "initial" scan and by about 1 % with the "optimized" scan and the averaged 4D scan. CONCLUSION Volume measurements performed with the dynamic phantom allowed us to validate the "optimized" 3D CT scan parameters because it accurately reflects the volume of a moving object. Radiotherapy departments without 4D CT should adapt scan parameters for internal target volume definition.
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Affiliation(s)
- M Ayadi
- Université Claude-Bernard Lyon I, 43 Boulevard du 11-Novembre-1918, 69622 Villeurbanne cedex, France.
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Bouilhol G, Arnaud A, Lesseur J, Ayadi M, Sarrut D, Claude L. Interobserver Variability in NSCLC Target Delineation for Stereotactic Body Radiation Therapy: A Four-dimensional Analysis. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bouilhol G, Ayadi M, Hau N, Gassa F, Sarrut D, Ginestet C, Claude L. TUMOR BASELINE SHIFT FOR NSCLC SBRT TREATMENT WITH CONE-BEAM CT IMAGE GUIDANCE. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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