Anatomical Adaptation-Early Clinical Evidence of Benefit and Future Needs in Lung Cancer.
Semin Radiat Oncol
; 29(3): 274-283, 2019 Jul.
Article
en En
| MEDLINE
| ID: mdl-31027644
ABSTRACT
Definitive treatment of locally advanced non-small-cell lung cancer with radiation is challenging. During the course of treatment, anatomical changes such as tumor regression, tumor displacement/deformation, pleural effusion, and/or atelectasis can result in a deviation of the administered radiation dose from the intended prescribed treatment and thereby worsen local control and toxicity. Adaptive radiotherapy can help correct for these changes and can be generally categorized into 3 philosophical paradigms (1) maintenance of prescribed dose to the initially defined target volume; (2) dose reduction to healthy organs while maintaining initial prescribed dose to a regressing tumor volume; or (3) dose escalation to a regressing tumor volume with isotoxicity to healthy organs. Numerous single institution studies have investigated these methods, and results from large prospective clinical trials will hopefully provide consensus on the method, utility, and efficacy of implementing adaptive radiation therapy (ART) in a clinical setting. Additional development into standardization and automation of the ART workflow, specifically in identifying when ART is warranted and in reducing the manual clinical effort needed to produce an adaptive plan, will be paramount to making ART feasible for the broader radiation therapy community.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Planificación de la Radioterapia Asistida por Computador
/
Carcinoma de Pulmón de Células no Pequeñas
/
Radioterapia Guiada por Imagen
/
Variación Anatómica
/
Neoplasias Pulmonares
Tipo de estudio:
Etiology_studies
/
Guideline
Límite:
Humans
Idioma:
En
Revista:
Semin Radiat Oncol
Asunto de la revista:
NEOPLASIAS
/
RADIOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Macao