| WANG Zhong-tang,LI Bao-sheng,SUN Hong-fu.Using SPECT-guidance to protect functional lung with optimizing intensity modulated radiotherapy in stage Ⅲ non-small cell lung cancer patients[J].Chinese Journal of Radiological Medicine and Protection,2008,28(5):471-474 |
| Using SPECT-guidance to protect functional lung with optimizing intensity modulated radiotherapy in stage Ⅲ non-small cell lung cancer patients |
| Received:May 08, 2008 |
| DOI： |
| KeyWords:Non-small cell lung cancer Intensity-modulated radiotherapy Single photon emission computed tomography Lung perfusion |
| FundProject: |
| Author Name | Affiliation | E-mail | | WANG Zhong-tang | Sixth Department of Radiation Oncology, Shandong Tumor Hospital, Jinan 250117, China | | | LI Bao-sheng | Sixth Department of Radiation Oncology, Shandong Tumor Hospital, Jinan 250117, China | baoshengli@yahoo.com | | SUN Hong-fu | Sixth Department of Radiation Oncology, Shandong Tumor Hospital, Jinan 250117, China | | | 方永存 | 250117 济南, 山东省肿瘤医院核医学科 | | | 陈进琥 | 250117 济南, 山东省肿瘤医院物理室 | | | 闫婧 | Sixth Department of Radiation Oncology, Shandong Tumor Hospital, Jinan 250117, China | |
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| Abstract:: |
| Objective To explore the possibility of using lung perfusion single photon emission computed tomography (SPECT) scans to protect functional lung with optimizing intensity modulated radiotherapy (IMRT) plan in patients with stage Ⅲ non-small cell lung cancer(NSCLC). Methods Twenty_four patients with stage Ⅲ NSCLC who were candidated for radiotherapy were enrolled. All patients had PET-CT scans and SPECT scans. The two sets of images were accurately co-registered in the planning system. SPECT images were used to define a volume of functional lung (FL) and non-functional lung (NFL). The region of ≥30% maximum radioactive counts was FL and the other region was NFL. Then SPECT images were classified by comparing lung perfusion deficit with area of radiological abnormality. Grade 0: no lung perfusion deficit. Grade 1: the size of radiological abnormality was similar to the area of lung perfusion deficit. Grade 2: the area of lung perfusion was bigger than that of radiological abnormality, and extended to 1 pulmonary lobe. Grade 3: the area of lung perfusion deficit exceed 1 pulmonary lobe. The optimized IMRT objective was to minimize the dose to FL. the difference between the two sets of IMRT plans was studied. Results All patients had lung perfusion deficits, 8 patients with grade 1 damage, 6 patients with grade 2 damage, and 10 patient with grade 3 damage. After IMRT plan optimized, both the percentage of whole lung volume received dose (WLV) and the percentage of functional lung volume received dose (FLV) were decreased. However, the FLVs was decreased more significantly. There was significant difference in WLV10, WLV15, WLV20, WLV25, WLV30 and FLV10, FLV15, FLV20, FLV25, FLV30 between the two sets of IMRT plans(P<0.05). Conclusions It is conrenient to SPECT-guidance to protect functional lung with optimizing IMRT in stage Ⅲ NSCLC patients, potentially reducing lung toxicity. |
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