Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T21:25:31.406Z Has data issue: false hasContentIssue false
  • English
  • Français

A treatment planning study comparison between supine and prone position for different lung tumour locations using CyberKnife TPS

Published online by Cambridge University Press:  17 May 2021

Hiroaki Akasaka Open the ORCID record for Hiroaki Akasaka [Opens in a new window] ,
Kazufusa Mizonobe ,
Yuya Oki ,
Kazuyuki Uehara ,
Aya Harada ,
Shuichiro Miyazaki ,
Keiji Kitatani ,
Tomonori Yabuuchi ,
Takeaki Ishihara  and
Daisuke Miyawaki
...Show all authors
Hiroaki Akasaka
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo650-0017, Japan
Kazufusa Mizonobe
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Yuya Oki
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Kazuyuki Uehara
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Aya Harada
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Shuichiro Miyazaki
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Keiji Kitatani
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Tomonori Yabuuchi
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
Takeaki Ishihara
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Daisuke Miyawaki
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Masao Nakayama
Affiliation:
Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo650-0017, Japan
Naritoshi Mukumoto
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Ryuichi Yada
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Ai Nakaoka
Affiliation:
Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo650-0017, Japan
Hikaru Kubota
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Hiroki Kawaguchi
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Satoshi Seno
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Ryohei Sasaki
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo650-0017, Japan
Hiroshi Mayahara*
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan
*
Author for correspondence: Hiroshi Mayahara, Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan. Tel: (+81)-78-304-4100. Fax: (+81)-78-304-0041. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

CyberKnife is the most advanced form of stereotactic body radiotherapy (SBRT) system that uses a robotic arm to deliver highly focused beams of radiation; however, a limitation is that it only irradiates from ceiling to floor direction. In patients with posterior lungs tumour who are positioned supine, normal lung tissue may suffer undesirable radiation injuries. This study compares the treatment planning between the prone set-up and the supine set-up for lung cancer in CyberKnife SBRT to decrease normal lung dose to avoid radiation side effects.

Materials and methods:

A human phantom was used to generate 108 plans (54 for prone and 54 for supine) using the CyberKnife planning platform. The supine and prone plans were compared in terms of the dosimetric characteristics, delivery efficiency and plan efficiency.

Results:

For posterior targets, the area of low-dose exposure to normal lungs was smaller in the prone set-up than in the supine set-up. V10 of the lungs was 7·53% and 10·47% (p < 0·001) in the anterior region, and 10·78% and 8·03% (p < 0·001) in the posterior region in the supine and prone set-up plans, respectively.

Conclusions:

The comparison between the prone set-up and the supine set-up was investigated with regard to target coverage and dose to organs at risk. Our results may be deployed in CyberKnife treatment planning to monitor normal tissue dose by considering patient positioning. This may assist in the design of better treatment plans and prevention of symptomatic radiation pneumonitis in lung cancer patients.

Keywords

CyberKnifelung cancerradiation pneumonitisradiotherapyset-up positionstereotactic body radiotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 309 - 314
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mehta, N, King, C R, Agazaryan, N, Steinberg, M, Hua, A, Lee, P. Stereotactic body radiation therapy and 3-dimensional conformal radiotherapy for stage I non-small cell lung cancer: a pooled analysis of biological equivalent dose and local control. Pract Radiat Oncol 2012; 2 (4): 288–295.CrossRefGoogle Scholar
Baker, R, Han, G, Sarangkasiri, S et al. Clinical and dosimetric predictors of radiation pneumonitis in a large series of patients treated with stereotactic body radiation therapy to the lung. Int J Radiat Oncol Biol Phys 2013; 85 (1): 190–195.CrossRefGoogle Scholar
Matsuo, Y, Shibuya, K, Nakamura, M et al. Dose-Volume metrics associated with radiation pneumonitis after stereotactic body radiation therapy for lung cancer. Int J Radiat Oncol Biol Phys 2012; 83 (4): e545–e549.CrossRefGoogle ScholarPubMed
Ueyama, T, Arimura, T, Takumi, K et al. Risk factors for radiation pneumonitis after stereotactic radiation therapy for lung tumours: clinical usefulness of the planning target volume to total lung volume ratio. Br J Radiol 2018; 91 (1086): 20170453.CrossRefGoogle ScholarPubMed
Nakamura, M, Nishimura, H, Nakayama, M et al. Dosimetric factors predicting radiation pneumonitis after CyberKnife stereotactic body radiotherapy for peripheral lung cancer. Br J Radiol 2016; 89 (1068): 20160560.CrossRefGoogle ScholarPubMed
Bradley, J. A review of radiation dose escalation trials for non-small cell lung cancer within the Radiation Therapy Oncology Group. Semin Oncol 2005; 32 (2 Suppl 3): S111–S113.CrossRefGoogle ScholarPubMed
Lee, C B, Stinchcombe, T E, Rosenman, J G, Socinski, M A. Therapeutic advances in local-regional therapy for stage III non-small-cell lung cancer: evolving role of dose-escalated conformal (3-dimensional) radiation therapy. Clin Lung Cancer 2006; 8 (3): 195–202.CrossRefGoogle ScholarPubMed
Kong, F M, Hayman, J A, Griffith, K A et al. Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (NSCLC): predictors for radiation pneumonitis and fibrosis. Int J Radiat Oncol Biol Phys 2006; 65 (4): 1075–1086.CrossRefGoogle ScholarPubMed
Kilby, W, Dooley, J R, Kuduvalli, G, Sayeh, S, Maurer, C R Jr The CyberKnife robotic radiosurgery system in 2010. Technol Cancer Res Treat 2010; 9 (5): 433–452.CrossRefGoogle ScholarPubMed
Nakamura, M, Nishikawa, R, Mayahara, H et al. Pattern of recurrence after CyberKnife stereotactic body radiotherapy for peripheral early non-small cell lung cancer. J Thorac Dis 2019; 11 (1): 214–221.CrossRefGoogle ScholarPubMed
Rossi, L, Breedveld, S, Heijmen, B J, Voet, P W, Lanconelli, N, Aluwini, S. On the beam direction search space in computerized non-coplanar beam angle optimization for IMRT-prostate SBRT. Phys Med Biol 2012; 57 (17): 5441–5458.CrossRefGoogle ScholarPubMed
Murali, V, Gopalakrishna Kurup, P G, Bhuvaneswari, N et al. Monte Carlo and ray tracing algorithms in the CyberKnife treatment planning for lung tumours—Comparison and validation. J Radiosurg SBRT 2013; 2 (2): 85–98.Google ScholarPubMed
Cao, Y, Zhu, X, Ju, X et al. Optimization of dose distributions of target volumes and organs at risk during stereotactic body radiation therapy for pancreatic cancer with dose-limiting auto-shells. Radiat Oncol 2018; 13 (1): 11.CrossRefGoogle ScholarPubMed
Yamashita, H, Nakagawa, K, Nakamura, N et al. Exceptionally high incidence of symptomatic grade 2-5 radiation pneumonitis after stereotactic radiation therapy for lung tumors. Radiat Oncol 2007; 2: 21.CrossRefGoogle ScholarPubMed
Guckenberger, M, Baier, K, Polat, B et al. Dose-Response relationship for radiation-induced pneumonitis after pulmonary stereotactic body radiotherapy. Radiother Oncol 2010; 97 (1): 65–70.CrossRefGoogle ScholarPubMed
Ong, C L, Palma, D, Verbakel, W F, Slotman, B J, Senan, S. Treatment of large stage I-II lung tumors using stereotactic body radiotherapy (SBRT): planning considerations and early toxicity. Radiother Oncol 2010; 97 (3): 431–436.CrossRefGoogle ScholarPubMed
Barriger, R B, Forquer, J A, Brabham, J G, et al. A dose-volume analysis of radiation pneumonitis in non-small cell lung cancer patients treated with stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 2012; 82 (1): 457–462.CrossRefGoogle ScholarPubMed
Stauder, M C, Macdonald, O K, Olivier, K R et al. Early pulmonary toxicity following lung stereotactic body radiation therapy delivered in consecutive daily fractions. Radiother Oncol 2011; 99 (2): 166–171.CrossRefGoogle ScholarPubMed
Ding, C, Chang, C H, Haslam, J, Timmerman, R, Solberg, T. A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac-based systems. J Appl Clin Med Phys 2010; 11 (3): 3223.CrossRefGoogle ScholarPubMed
Chan, M K H, Kwong, D L W, Law, G M L et al. Dosimetric evaluation of four-dimensional dose distributions of CyberKnife and volumetric-modulated arc radiotherapy in stereotactic body lung radiotherapy. J Appl Clin Med Phys 2013;14 (4): 4229.CrossRefGoogle ScholarPubMed
Descovich, M, Ma, L, Chuang, C F, Larson, D A, Barani, I J. Comparison between prone and supine patient setup for spine stereotactic body radiosurgery. Technol Cancer Res Treat 2012; 11 (3): 229–236.CrossRefGoogle ScholarPubMed
Fürweger, C, Drexler, C, Muacevic, A, Wowra, B, de Klerck, E C, Hoogeman, M S. CyberKnife robotic spinal radiosurgery in prone position: dosimetric advantage due to posterior radiation access?. J Appl Clin Med Phys 2014; 15 (4): 4427.CrossRefGoogle ScholarPubMed
Nakayama, M, Nishimura, H, Mayahara, H et al. Clinical log data analysis for assessing the accuracy of the CyberKnife fiducial-free lung tumor tracking system. Pract Radiat Oncol 2018; 8 (2): e63–e70.CrossRefGoogle ScholarPubMed