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Radiotherapy
ART for lung: mid-treatment adaptation
Significant decrease of +/- 30% in tumor and target volume
Radiotherapy
ART for lung: mid-treatment adaptation
Radiotherapy
Shrinkage
Dissolvement
Sonke et al 2010
Note:
Arrows
point at
vessels
What does a smaller image of the tumor mean?
Start
Half way
Radiotherapy
ART for lung: mid-treatment adaptation
15 patients stage III lung cancer
Replanning after 44 of 66 Gy
Clinical trial
Radiotherapy
Do you need deformable registration if
you want to do adaptive radiotherapy?
No
: if all individual plans are
safe
AND
with
adequate coverage
, the summation
will be safe and appropriate for the target as
well
Yes
: if you want to know the
actual
dose to the OAR’s
Radiotherapy
In summary:
Ask yourself what kind of adaptation you want
Act accordingly
Careful when adapting on a smaller
projection of the tumor:
Would you have accepted an upfront
underdosage to the microscopic part of the
original CTV?