Dosimetric analysis of normal tissue toxicity in 3D conformal radiotherapy planning with fused PET-CT imaging in non-small cell lung carcinoma
Journal Title: IP International Journal of Medical Paediatrics and Oncology - Year 2018, Vol 4, Issue 1
Abstract
Introduction The prime modality for inoperable NSCLC is radiation therapy and or chemoradiation and better results can be achieved by a higher dose of radiation However dose escalation is difficult due to presence of critical and dose limiting sensitive structures in the vicinity of lung Therefore success of radiotherapy in such tumors solely depends on the selective delivery of adequate dose to target with minimal irradiation of surrounding structures The precision in target and normal tissue delineation needs to be achieved So the aim of this study is to explore the possibility of using fused PETCT images for accurate target and normal tissue delineation in 3Dconformal radiotherapy planning in patients of carcinoma lung NSCLC who are referred to us for radical radiotherapyMaterials and Methods Itrsquos a hospital based prospective study in which 14n cancer patients who had biopsy proven NSCLC and were referred to us for radical radiotherapy After CT simulation and FDGhybrid PET data sets were transferred to CMS planning system The coregistration was done in Focal Pro using an auto fusion 3D rotation and translation rigid body program and the fiducial markers The gross tumor volume GTV planning target volume PTV and normal tissue parameters were defined using the CT data and PETCT data 3DCRT plans were generated for both CT data and PETCT data sets and dosimetric analysis was done for sameResults The mean age was 65 yrs 785 11 patients are male and 215 3 are female The registration of fused images of PET with planning CT scan decreased the gross tumor volume GTV in 10 patients 7142 decreased volume in 4 patients 2858 The 3DCRT planes were modified in 5patients 35 CTPET planning did not reduce the radiation fields in all patients When all constraints of the lung esophagus and spinal cord were taken into account normal tissue exposure was reduced with use of CTPET V20 decreased from 3186 plusmn 417 to 2866 plusmn 423 p 02676 and MLD was 1708 plusmn194 Gy to 1553 plusmn 202 Gy p lt 006763 MED decreased from 1811 plusmn 25 Gy to 1511 plusmn 39 Gy p 00085Conclusion Our findings extend the conclusion of observational studies in which FDGPET has already been used to improve delineation of GTV and normal tissue parameters The tumor volume and normal tissue irradiation parameters were significantly reduced It showed 35 alteration in radiotherapy treatment plan PETCT should be incorporatedKeywords NSCLC PETCT 3DCRT Normal tissue toxicity
Authors and Affiliations
Dilip Sandipan Nikam, B. C. Goswami
Keywords
Related Articles
- EP ID EP482912
- DOI 10.18231/2455-6793.2018.0008
- Views 106
- Downloads 0
Clinico epidemiological study of measles, pertussis, diphtheria and tetanus cases in a tertiary care hospital of western Rajasthan
Introduction Vaccine preventable infectious diseases like measles whooping cough tetanus and diphtheria are very important causes of morbidity and mortality in the younger infants and children in developing countries The...
Neonatal candida guilliermondii sepsis-An unusual bug in neonatal intensive care unit
Fungemia particularly due to candida species is a well-recognized entity in Neonatal Intensive Care Units(NICU). A cause of concern is the increasing occurrence of sepsis due to non-albicans candida species. These are as...
The tricky thrombus: A rare inborn error of metabolism with venous thrombosis
Hyperhomocysteinemia is an inborn error of amino acid metabolism (IEM) in which homocysteine accumulates in the blood and produces a slowly evolving clinical syndrome.(1) Late presentation is rarely seen in paediatric ag...
Morbidities of ELBW babies affecting their outcome: An observational study
Introduction: There are significant risk factors like birth asphyxia, HMD, sepsis, pulmonary hemorrhage, IVH etc. predicting survival of the ELBW neonates and is associated with increased mortality. Expectant parents of...
Periampullary Carcinoma with Skull Metastasis: A rare case report
Periampullary cancer consist of pancreatic cancer, carcinoma of ampulla of vater, distal common bile duct and duodenum. With the use of multimodality treatment, the prognosis of periampullary carcinoma has been improved....