Intra- and interfraction breathing variations during curative radiotherapy for lung cancer

Trine Juhler Nøttrup; Stine Sofia Korreman; Anders Navrsted Pedersen; Lasse Rye Aarup; Håkan Nyström; Mikael Olsen; Lena Specht

doi:10.1016/j.radonc.2007.05.026

Intra- and interfraction breathing variations during curative radiotherapy for lung cancer

Trine Juhler Nøttrup, Stine Sofia Korreman, Anders Navrsted Pedersen, Lasse Rye Aarup, Håkan Nyström, Mikael Olsen, Lena Specht

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

87 Citationer (Scopus)

Abstract

Udgivelsesdato: 2007-Jul

Originalsprog	Engelsk
Tidsskrift	Radiotherapy & Oncology
Vol/bind	84
Udgave nummer	1
Sider (fra-til)	40-8
Antal sider	9
ISSN	0167-8140
DOI	https://doi.org/10.1016/j.radonc.2007.05.026
Status	Udgivet - 2007

Bibliografisk note

Keywords: Aged; Dose Fractionation; Exhalation; Female; Humans; Lung Neoplasms; Male; Middle Aged; Respiration; Respiratory Mechanics

Adgang til dokumentet

10.1016/j.radonc.2007.05.026

Citationsformater

@article{9b1a01804c7d11df928f000ea68e967b,

title = "Intra- and interfraction breathing variations during curative radiotherapy for lung cancer",

abstract = "BACKGROUND AND PURPOSE: This study aimed at quantifying the breathing variations among lung cancer patients over full courses of fractionated radiotherapy. The intention was to relate these variations to the margins assigned to lung tumours, to account for respiratory motion, in fractionated radiotherapy. MATERIALS AND METHODS: Eleven lung cancer patients were included in the study. The patients' chest wall motions were monitored as a surrogate measure for breathing motion during each fraction of radiotherapy by use of an external optical marker. The exhale level variations were evaluated with respect to exhale points and fraction-baseline, defined for intra- and interfraction variations respectively. The breathing amplitude was evaluated as breathing cycle amplitudes and fraction-max-amplitudes defined for intra- and interfraction breathing, respectively. RESULTS: The breathing variations over a full treatment course, including both intra- and interfraction variations, were 15.2mm (median over the patient population), range 5.5-26.7mm, with the variations in exhale level as the major contributing factor. The median interfraction span in exhale level was 14.8mm, whereas the median fraction-max-amplitude was 6.1mm (median of patient individual SD 1.4). The median intrafraction span in exhale level was 1.6mm, and the median breathing cycle amplitude was 4.0mm (median of patient individual SD 1.4). CONCLUSIONS: The variations in externally measured exhale levels are larger than variations in breathing amplitude. The interfraction variations in exhale level are in general are up to 10 times larger than intrafraction variations. Margins to account for respiratory motion cannot safely be based on one planning session, especially not if relying on measuring external marker motion. Margins for lung tumours should include interfraction variations in breathing.",

author = "{Juhler N{\o}ttrup}, Trine and Korreman, {Stine Sofia} and Pedersen, {Anders Navrsted} and Aarup, {Lasse Rye} and H{\aa}kan Nystr{\"o}m and Mikael Olsen and Lena Specht",

note = "Keywords: Aged; Dose Fractionation; Exhalation; Female; Humans; Lung Neoplasms; Male; Middle Aged; Respiration; Respiratory Mechanics",

year = "2007",

doi = "10.1016/j.radonc.2007.05.026",

language = "English",

volume = "84",

pages = "40--8",

journal = "Radiotherapy & Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

number = "1",

}

TY - JOUR

T1 - Intra- and interfraction breathing variations during curative radiotherapy for lung cancer

AU - Juhler Nøttrup, Trine

AU - Korreman, Stine Sofia

AU - Pedersen, Anders Navrsted

AU - Aarup, Lasse Rye

AU - Nyström, Håkan

AU - Olsen, Mikael

AU - Specht, Lena

N1 - Keywords: Aged; Dose Fractionation; Exhalation; Female; Humans; Lung Neoplasms; Male; Middle Aged; Respiration; Respiratory Mechanics

PY - 2007

Y1 - 2007

N2 - BACKGROUND AND PURPOSE: This study aimed at quantifying the breathing variations among lung cancer patients over full courses of fractionated radiotherapy. The intention was to relate these variations to the margins assigned to lung tumours, to account for respiratory motion, in fractionated radiotherapy. MATERIALS AND METHODS: Eleven lung cancer patients were included in the study. The patients' chest wall motions were monitored as a surrogate measure for breathing motion during each fraction of radiotherapy by use of an external optical marker. The exhale level variations were evaluated with respect to exhale points and fraction-baseline, defined for intra- and interfraction variations respectively. The breathing amplitude was evaluated as breathing cycle amplitudes and fraction-max-amplitudes defined for intra- and interfraction breathing, respectively. RESULTS: The breathing variations over a full treatment course, including both intra- and interfraction variations, were 15.2mm (median over the patient population), range 5.5-26.7mm, with the variations in exhale level as the major contributing factor. The median interfraction span in exhale level was 14.8mm, whereas the median fraction-max-amplitude was 6.1mm (median of patient individual SD 1.4). The median intrafraction span in exhale level was 1.6mm, and the median breathing cycle amplitude was 4.0mm (median of patient individual SD 1.4). CONCLUSIONS: The variations in externally measured exhale levels are larger than variations in breathing amplitude. The interfraction variations in exhale level are in general are up to 10 times larger than intrafraction variations. Margins to account for respiratory motion cannot safely be based on one planning session, especially not if relying on measuring external marker motion. Margins for lung tumours should include interfraction variations in breathing.

AB - BACKGROUND AND PURPOSE: This study aimed at quantifying the breathing variations among lung cancer patients over full courses of fractionated radiotherapy. The intention was to relate these variations to the margins assigned to lung tumours, to account for respiratory motion, in fractionated radiotherapy. MATERIALS AND METHODS: Eleven lung cancer patients were included in the study. The patients' chest wall motions were monitored as a surrogate measure for breathing motion during each fraction of radiotherapy by use of an external optical marker. The exhale level variations were evaluated with respect to exhale points and fraction-baseline, defined for intra- and interfraction variations respectively. The breathing amplitude was evaluated as breathing cycle amplitudes and fraction-max-amplitudes defined for intra- and interfraction breathing, respectively. RESULTS: The breathing variations over a full treatment course, including both intra- and interfraction variations, were 15.2mm (median over the patient population), range 5.5-26.7mm, with the variations in exhale level as the major contributing factor. The median interfraction span in exhale level was 14.8mm, whereas the median fraction-max-amplitude was 6.1mm (median of patient individual SD 1.4). The median intrafraction span in exhale level was 1.6mm, and the median breathing cycle amplitude was 4.0mm (median of patient individual SD 1.4). CONCLUSIONS: The variations in externally measured exhale levels are larger than variations in breathing amplitude. The interfraction variations in exhale level are in general are up to 10 times larger than intrafraction variations. Margins to account for respiratory motion cannot safely be based on one planning session, especially not if relying on measuring external marker motion. Margins for lung tumours should include interfraction variations in breathing.

U2 - 10.1016/j.radonc.2007.05.026

DO - 10.1016/j.radonc.2007.05.026

M3 - Journal article

C2 - 17588697

SN - 0167-8140

VL - 84

SP - 40

EP - 48

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

IS - 1

ER -