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Breathing during radiotherapy - how to hit the treatment target without causing collateral damage
Date:5/11/2012

in cases where large tumour motion was involved.

"In a conventional 3D scan," Ms van den Boomen explained, "the scan is taken with the patient in the treatment position, but not taking breathing motion into account. Due to the fact that it takes around two minutes to perform the scan, the result is blurred due to the motion of the tumour. With 4D scanning you can account for breathing because the software creates a number of datasets at different phases of the breathing cycle, thus freezing the tumour in a certain position."

4D scanning equipment has only become available recently, and therefore the number of institutes using it is still limited. However, the researchers say, the results are so impressive that their hospital is now performing it routinely in cases where there is large tumour movement.

"The results from this study have shown that we can safely apply the 'mid-ventilation' concept, where we only irradiate part of the tumour trajectory instead of the entire volume in which the tumour resides during a breathing cycle. Thus we can reduce treatment volumes, with the result that patients have fewer complications," said Ms van den Boomen.

In another study presented to the conference, Gauthier Bouilhol, M.Sc, from the Centre Lon Brard, Lyon, described how he and colleagues from CREATIS (CNRS UMR5220, Inserm U1044) have developed a model to adjust the method currently used for the calculation of safety margins to account for respiratory motion asymmetry during radiotherapy.

"When a patient breathes during radiotherapy treatment," Mr. Bouilhol explained, "the tumour may also move. The normal way of calculating the treatment margins to compensate for potential errors is based on a symmetrical model. But if tumour motion is asymmetric the model is wrong."

The researchers suggest a new model that takes into account the differences between the two margins involved in inhale and exhale motion. "We believe tha
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Contact: Mary Rice
mary.rice@riceconseil.eu
European Society for Radiotherapy and Oncology (ESTRO)
Source:Eurekalert

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