Author of

• 17783

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  P2.05 - Poster Session with Presenters Present (ID 463)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Radiotherapy
  • Presentations: 2
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17826

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    P2.05-043 - Lung Tumour Motion Kilovoltage Intrafraction Monitoring (KIM): First Clinical Results (ID 5538)

    14:30 - 14:30  |  Author(s): F. Hegi-Johnson
    • Abstract

    Background:
    Lung tumour positional uncertainty has been identified as a major issue that deteriorates the efficacy of radiotherapy. The recent development of the Kilovoltage intrafraction monitoring (KIM) which uses widely available gantry-mounted kilovoltage (kV) imager has been applied to prostate motion monitoring. This study reports the first clinical result of KIM for lung cancer radiotherapy with an Elekta machine.
    
    Methods:
    A locally advanced stage IIIlung cancer patient undergoing conventionally fractionated VMAT was enrolled in an ethics-approved study of KIM. A Gold Anchor fiducial marker (0.4 mm diameter x 20 mm length) was implanted in the tumour near the right hilum (Fig 1, left). kV images were acquired at 5.5 Hz during treatment. Post-treatment, markers were segmented and reconstructed to obtain 3D tumour trajectories. A Microsoft Kinect audio and depth sensing device was also mounted on the couch to get the external respiratory signal. Figure 1 Figure 1. kV image of the Gold Anchor marker (left) and the KIM measured lung tumour 3D motion and the external Kinect signal (right).
    
    
    
    Results:
    Our method was successfully applied for the first KIM lung patient. The fiducial marker was visible on 62.9% of the kV images. The average lung tumour motion (mean ± SD) in superior-inferior (SI), anterior-posterior (AP) left-right (LR), directions were 0.27±7.52, -0.09±3.37, and -0.64±4.55 mm respectively. Seven fractions of lung tumour 3D motion and Kinect external signal were acquired, with the representative result illustrated (Fig 1, right).
    
    Conclusion:
    This is the first time that KIM has been used for intrafractional tumour motion monitoring during lung cancer radiotherapy, and also the first implementation of KIM on an Elekta imaging platform. This clinical translational research milestone paves the way for the broad implementation of image guidance to facilitate the detection and correction of geometric error for lung radiotherapy, and resultant improved clinical outcomes.
    
    

  • 17835

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    P2.05-052 - A Systematic Review and Meta-Analysis of Pneumonitis in Radically Treated NSCLC Patients: SABR. vs. Non-SABR Treatment (ID 5111)

    14:30 - 14:30  |  Author(s): F. Hegi-Johnson
    • Abstract

    Background:
    Purpose: SABR is popular because of the high rates of local control seen in lung cancer patients. However, prospective head to head trial data comparing the toxicity of SABR to conventionally fractionated radiotherapy are still awaited. We compare pneumonitis rates in SABR vs. non-SABR treatment for early stage lung cancer patients.
    
    Methods:
    Methods: A PUBMED search of all human, English language papers on SABR and on-SABR radically treated early stage lung cancer patients was performed until March 2016. The date range for the non-SABR patients extended back to January 1995, but the first 3D-CRT SABR papers assessed were found in 2003. Results of these searches were filtered in accordance to a set of eligibility criteria and analysed in accordance with the PRISMA Guidelines.
    
    Results:
    Results: The systematic search yielded a total of 184 SABR and 360 non-SABR articles, which were filtered down to 75 SABR and 23 non-SABR articles. SABR patients were older than non-SABR patients with 35/75 SABR papers and 0/23 non-SABR papers recording a median age >75 years. Meta-analysis did not demonstrate a significant difference in pneumonitis rates between patients receiving SABR [11.4% ( 95% CI of 9.7 to 13.3)] and non-SABR treatment [14.4% (95% CI of 10.6 to 18.8)].
    
    Conclusion:
    Conclusion: Although meta-analysis did not confirm that SABR had lower rates of pneumonitis, it appears that SABR patients are older, and thus potentially frailer than the non-SABR radically treated patients. SABR is safe and has justifiably become the treatment of choice for inoperable patients.