Improved adaptive radiotherapy to adjust for anatomical alterations during curative treatment for locally advanced lung cancer

• Main Authors: Maria Moksnes Bjaanæs, Erlend Peter Skaug Sande, Øyvind Loe, Christina Ramberg, Tove Mette Næss, Andreas Ottestad, Lotte V. Rogg, Jørund Graadal Svestad, Vilde Drageset Haakensen
• Format: Article
• Language: English
• Published: Elsevier 2021-04-01
• Series: Physics and Imaging in Radiation Oncology
• Subjects: Adaptive radiotherapy; Cone-beam CT; Re-calculation of radiation doses; Lung cancer
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405631621000233

Anatomical changes during chemoradiation for lung cancer may decrease dose to the target or increase dose to organs at risk. To assess our ability to identify clinically significant anatomical alterations, we followed 67 lung cancer patients by daily cone-beam CT scans to ensure correct patient positioning and observe anatomical alterations. We also re-calculated the original dose distribution on a planned control CT scan obtained halfway during the treatment course to identify anatomical changes that potentially affected doses to the target or organs at risk. Of 66 patients who completed the treatment, 12 patients needed adaptation, two patients were adapted twice. We conclude that daily cone-beam CT and routines at the treatment machine discover relevant anatomical changes during curative radiotherapy for patients with lung cancer without additional imaging.