Consequences of additional use of PET information for target volume delineation and radiotherapy dose distribution for esophageal cancer

Christina T. Muijs*, Liesbeth M. Schreurs, Dianne M. Busz, Jannet C. Beukema, Arnout J. van der Borden, Jan Pruim, Eric J. Van der Jagt, John Th. Plukker, Johannes A. Langendijk

*Corresponding author for this work

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Abstract

Background and purpose. To determine the consequences of target volume (TV) modifications, based on the additional use of PET information, on radiation planning, assuming PET/CT-imaging represents the title extent of the tumour

Materials and methods. For 21 patients with esophageal cancer, two separate TV's were retrospectively defined based on CT (CT-TV) and co-registered PET/CT Images (I'ET/CT-TV). Two 3D-CRT plans (prescribed close 504 Gy) were constructed to cover. the corresponding TV's. Subsequently, these plans were compared for. target coverage. normal tissue dose-volume histograms and the corresponding normal tissue complication probability (NTCP) values

Results The addition of PET led to the modification of CT-TV with at least 10% in 12 of 21 patients (57%) (reduction in 9. enlargement in 3). PET/Cr-TV was inadequately coveted by the CT-based treatment plan in 8 patients (36%) Treatment plan modifications resulted in significant changes (p <0 05) in dose distributions to heart and lungs Cot responding changes in NTCP values ranged horn -3% to +2% for. radiation pneumonitis and from -0 2% to +12% for cardiac mortality

Conclusions. This study demonstrated that TV's based on CT might exclude PET-avid disease Consequences are under dosing and thereby possibly ineffective treatment Moreover. the addition of PET in radiation planning might result in clinical Important changes in NTCP (C) 2009 Elsevier Ireland Ltd All rights reserved Radiotherapy and Oncology 93 (2009) 447-453

Original languageEnglish
Pages (from-to)447-453
Number of pages7
JournalRadiotherapy and Oncology
Volume93
Issue number3
DOIs
Publication statusPublished - Dec-2009

Keywords

  • PET/CT
  • Esophageal cancer
  • Tumour delineation
  • NTCP
  • POSITRON-EMISSION-TOMOGRAPHY
  • PREDICTING RADIATION PNEUMONITIS
  • CELL LUNG-CANCER
  • CONCURRENT CHEMORADIATION
  • HISTOGRAM PARAMETERS
  • COMPUTED-TOMOGRAPHY
  • FDG-PET
  • CARCINOMA
  • IMPACT
  • CT

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