Adaptive radiation therapy for lung cancer

Both correction-based and response-based adaptations can be done via offline adaptive radiation therapy. Arguably, one of the most critical components of adaptive radiotherapy of the lung is the mapping of dose from the initial treatment planning image onto the adaptive planning image for dose accumulation. Since changes in lung function are common, and many times are the reason for an adaptation in lung cancer therapy, repeat evaluation of respiratory motion is essential. Adaptive radiotherapy in the lung is often performed based on functional imaging, specifically positron emission tomography, to identify the active region of the tumor and/or function of the lung. Quality assurance (QA) for adaptive radiation therapy is multifaceted, in that quality control is required for many distinct steps at varying time scales. Online re-planning requires a likely departure from more conventional measurement-based QA techniques due to the patient being on the table and the need for efficiency.