TY - JOUR
T1 - Image-guided radiation therapy for non-small cell lung cancer
AU - Chang, Joe Y.
AU - Dong, Lei
AU - Liu, Helen
AU - Starkschall, George
AU - Balter, Peter
AU - Mohan, Radhe
AU - Liao, Zhongxing
AU - Cox, James D.
AU - Komaki, Ritsuko
N1 - Funding Information:
Dr. Chang is a recipient of the Research Scholar Award from the Radiological Society of North America and a Career Developmental Award from The University of Texas M. D. Anderson Cancer Center NIH Lung Cancer SPORE.
PY - 2008/2
Y1 - 2008/2
N2 - Recent developments in image-guided radiotherapy are ushering in a new era of radiotherapy for lung cancer. Positron emission tomography/computed tomography (PET/CT) has been shown to improve targeting accuracy in 25 to 50% of cases, and four-dimensional CT scanning helps to individualize radiotherapy by accounting for tumor motion. Daily on-board imaging reduces treatment set-up uncertainty and provides information about daily organ motion and variations in anatomy. Image-guided intensity-modulated radiotherapy may allow for the escalation of radiotherapy dose with no increase in toxicity. More importantly, treatment adaptations based on anatomic changes during the course of radiotherapy and dose painting within involved lesions using functional imaging such as PET may further improve clinical outcomes of lung cancer patients and potentially lead to new clinical trials. Image-guided stereotactic radiotherapy can achieve local control rates exceeding 90% through the use of focused, hypofractionated, highly biologically effective doses. These novel approaches were considered experimental just a few years ago, but accumulating evidence of their potential for significantly improving clinical outcomes is leading to their inclusion in standard treatments for lung cancer at major cancer centers. In this review article, we focus on novel image-guided radiotherapy approaches, particularly PET/CT and four-dimensional CT-based radiotherapy planning and on-board image-guided delivery, stereotactic radiotherapy, and intensity-modulated radiotherapy for mobile nonsmall cell lung cancer.
AB - Recent developments in image-guided radiotherapy are ushering in a new era of radiotherapy for lung cancer. Positron emission tomography/computed tomography (PET/CT) has been shown to improve targeting accuracy in 25 to 50% of cases, and four-dimensional CT scanning helps to individualize radiotherapy by accounting for tumor motion. Daily on-board imaging reduces treatment set-up uncertainty and provides information about daily organ motion and variations in anatomy. Image-guided intensity-modulated radiotherapy may allow for the escalation of radiotherapy dose with no increase in toxicity. More importantly, treatment adaptations based on anatomic changes during the course of radiotherapy and dose painting within involved lesions using functional imaging such as PET may further improve clinical outcomes of lung cancer patients and potentially lead to new clinical trials. Image-guided stereotactic radiotherapy can achieve local control rates exceeding 90% through the use of focused, hypofractionated, highly biologically effective doses. These novel approaches were considered experimental just a few years ago, but accumulating evidence of their potential for significantly improving clinical outcomes is leading to their inclusion in standard treatments for lung cancer at major cancer centers. In this review article, we focus on novel image-guided radiotherapy approaches, particularly PET/CT and four-dimensional CT-based radiotherapy planning and on-board image-guided delivery, stereotactic radiotherapy, and intensity-modulated radiotherapy for mobile nonsmall cell lung cancer.
KW - 4-D CT
KW - Adapted radiotherapy
KW - Image-guided radiation therapy
KW - Intensity-modulated radiotherapy
KW - Nonsmall cell lung cancer
KW - PET/CT
KW - Stereotactic body radiotherapy
KW - Target volume delineation
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U2 - 10.1097/JTO.0b013e3181622bdd
DO - 10.1097/JTO.0b013e3181622bdd
M3 - Article
C2 - 18303441
AN - SCOPUS:40049112095
SN - 1556-0864
VL - 3
SP - 177
EP - 186
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 2
ER -