Impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with intensity-modulated radiotherapy

Uchinami, Yusuke; Suzuki, Ryusuke; Katoh, Norio; Taguchi, Hiroshi; Yasuda, Koichi; Miyamoto, Naoki; Ito, Yoichi M.; Shimizu, Shinichi; Shirato, Hiroki

Impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with intensity-modulated radiotherapy

Uchinami, Yusuke; Suzuki, Ryusuke; Katoh, Norio et al.

Journal of applied clinical medical physics, 2019, 20(8), 78-86

Permalink : https://hdl.handle.net/2115/75508

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https://doi.org/10.1002/acm2.12681			28

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アクセス権	open access
URI	https://hdl.handle.net/2115/75508
タイトル	Impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with intensity-modulated radiotherapy
著者	Uchinami, Yusuke ; Suzuki, Ryusuke ; Katoh, Norio ; Taguchi, Hiroshi ; Yasuda, Koichi ; Miyamoto, Naoki ; Ito, Yoichi M. ; Shimizu, Shinichi ; Shirato, Hiroki
著者名 Uchinami, Yusuke
e-Rad_Researcher 00400052 著者名 Suzuki, Ryusuke
e-Rad_Researcher 80572495 著者名 Katoh, Norio
e-Rad_Researcher 90374454 著者名 Taguchi, Hiroshi
e-Rad_Researcher 00431362 著者名 Yasuda, Koichi
e-Rad_Researcher 00552879 著者名 Miyamoto, Naoki
e-Rad_Researcher 10334236 著者名 Ito, Yoichi M.
e-Rad_Researcher 50463724 著者名 Shimizu, Shinichi
e-Rad_Researcher 20187537 著者名 Shirato, Hiroki
言語	英語
キーワード	interplay effects
	organ motion
	stomach IMRT
	stomach lymphoma
発行日	2019-08-19
出版者	John Wiley & Sons
収録物名	Journal of applied clinical medical physics
巻(号)	20(8)
ページ	78-86
抄録	Purpose Interplay effects may influence dose distributions to a moving target when using dynamic delivery techniques such as intensity-modulated radiotherapy (IMRT). The aim of this study was to evaluate the impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with IMRT. Methods Ten patients who had been treated with IMRT for stomach lymphomas were enrolled. The clinical target volume (CTV) was contoured as the whole stomach. Considering interfractional uncertainty, the internal target volume (ITV) margin was uniformly 1.5 cm to the CTV and then modified based on the 4DCT images in case of the large respiratory motion. The planning target volume (PTV) was created by adding 5 mm to the ITV. The impact of organ motion on the volumetric and dosimetric parameters was evaluated retrospectively (4D simulation). The organ motion was reproduced by shifting the isocenter on the radiation treatment planning system. Several simulation plans were created to test the influence of the beam-on timing in the respiration cycle on the dose distribution. The homogeneity index (HI), volume percentage of stomach covered by the prescribed dose (V-p), and D-99 of the CTV were evaluated. Results The organ motion was the largest in the superior-inferior direction (10.1 +/- 4.5 mm [average +/- SD]). Stomach volume in each respiratory phase compared to the mean volume varied approximately within a +/- 5% range in most of the patients. The PTV margin was sufficiently large to cover the CTV during the IMRT. There was a significant reduction in V-p and D-99 but not in HI in the 4D simulation in free-breathing and multiple fractions compared to the clinically-used plan (P < 0.05) suggesting that interplay effects deteriorate the dose distribution. The absolute difference of D-99 was less than 1% of the prescribed dose. Conclusions There were significant interplay effects affecting the dose distribution in stomach IMRT. The magnitude of the dose reduction was small when patients were treated on free-breathing and multiple fractions.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution 4.0 International
PISSN	1526-9914
関連情報	PMID 31400082
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1002/acm2.12681