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Title: Protocol Needed to Monitor Anatomical Changes During Radiotherapy for Lung Cancer: Presented at ELCC
URL: http://www.pslgroup.com/dg/2205F6.htm
Doctor's Guide
April 29, 2008

By Timothy A. O'Leary

GENEVA -- April 29, 2008 -- To ensure that radiotherapy for lung cancer hits its intended target, a protocol is needed to monitor anatomical changes that may occur during treatment, according to evidence presented here at the 1st European Lung Cancer Conference (ELCC).

Starting in 2006, Marieke Van Zwienen, MD, Radiation Oncologist, The Netherlands Cancer Institute, Amsterdam, Netherlands, and her collaborators studied a cohort of 114 patients with lung cancer who were treated with conventional cone-beam radiotherapy at a dose of 45 to 88 Gy over 5 to 6 weeks.

Throughout treatment, images of the tumours and the surrounding tissue were taken repetitively and in 3 dimensions to allow researchers to follow any anatomical changes.

Anatomical changes are not uncommon in radiotherapy. Patients lose weight, tumours shrink, lungs fail to inflate, and fluid collects between layers of tissue. The study's purpose was to quantify the changes.

Half of the patients manifested significant anatomical changes, Dr. Van Zwienen said in her presentation on April 25. Forty percent of patients showed visible tumour regression, and 1% showed tumour progression.

In the 41 patients with tumour regression, the size of the tumours decreased an average of 37% over the course of treatment. In 24 patients, reductions of greater than 25% were seen by the fourth week of treatment.

To illustrate the evidence of anatomical changes that could affect treatment, Dr. Van Zwienen presented radiographic images of tumours that were, to a significant degree, no longer situated in the target area of the radiation.

In 6 patients, the anatomical change required retargeting of the radiation beam.

"A protocol is needed to monitor anatomical changes during treatment and quantify whether the delivered dose meets the treatment intent," Dr. Van Zwienen said.


[Presentation title: Anatomical Changes During Radiotherapy of Lung Cancer Patients. Abstract 251O]

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