ArticleFrontiers in oncology2022
Patient selection, inter-fraction plan robustness and reduction of toxicity risk with deep inspiration breath hold in intensity-modulated radiotherapy of locally advanced non-small cell lung cancer.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 11 citations in OpenAlex.
- Structure visibility and online adaptation suitability of a new high-performance ring-gantry cone-beam computed tomography imaging system in thoracic radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Comparative dosimetric analysis of deep inspiration breath-hold versus free breathing radiotherapy in lung cancer: special emphasis on cardiac and subcardiac structure protection.Technical innovations & patient support in radiation oncology · 2026Article
- Initial Experience with Correlation Object-Based DRR Targeting Using Stereoscopic X-Ray Imaging in Lung SBRT.Cancers · 2026Article
- Comparison of deep inspiration breath hold and free breathing intensity modulated proton therapy of locally advanced lung cancer.Physics and imaging in radiation oncology · 2024Article
- Dosimetric comparison of four radiotherapy techniques for stage III non‑small cell lung cancer.Oncology letters · 2023Article
- Motion and dosimetric criteria for selecting gating technique for apical lung lesions in magnetic resonance guided radiotherapy.Frontiers in oncology · 2023Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
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Abstract
Background: State-of-the-art radiotherapy of locally advanced non-small cell lung cancer (LA-NSCLC) is performed with intensity-modulation during free breathing (FB). Previous studies have found encouraging geometric reproducibility and patient compliance of deep inspiration breath hold (DIBH) radiotherapy for LA-NSCLC patients. However, dosimetric comparisons of DIBH with FB are sparse, and DIBH is not routinely used for this patient group. The objective of this simulation study was therefore to compare DIBH and FB in a prospective cohort of LA-NSCLC patients treated with intensity-modulated radiotherapy (IMRT). Methods: For 38 LA-NSCLC patients, 4DCTs and DIBH CTs were acquired for treatment planning and during the first and third week of radiotherapy treatment. Using automated planning, one FB and one DIBH IMRT plan were generated for each patient. FB and DIBH was compared in terms of dosimetric parameters and NTCP. The treatment plans were recalculated on the repeat CTs to evaluate robustness. Correlations between ΔNTCPs and patient characteristics that could potentially predict the benefit of DIBH were explored. Results: DIBH reduced the median D Conclusion: Compared to FB, DIBH allowed for smaller target volumes and similar target coverage. DIBH reduced the lung and heart dose, as well as the risk of radiation pneumonitis and 2-year mortality, for 92% and 74% of LA-NSCLC patients, respectively. However, the advantages varied considerably between patients, and the ability to reduce the risk of 2-year mortality was dependent on tumor location. Evaluation of repeat CTs showed similar robustness of the dose distributions with each technique.
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