International Journal of Radiation Research
نشریه پرتو پژوه
Int J Radiat Res
Basic Sciences
http://ijrr.com
79
journal79
2322-3243
2345-4229
10.61186/ijrr
en
jalali
1399
7
1
gregorian
2020
10
1
18
4
online
1
fulltext
en
The colossal circumvention of the lung lesion during lung stereotaxy
Medical Physics
Medical Physics
مطالعه موردي
Case Report
<div style="text-align: justify;">This is a case report on stereotaxic (Stereotactic Body Radiotherapy-SBRT) for lung cancer located in the left lower lobe (Segment 6, S6). There have been no reports on marked displacement of the peripheral lung cancer during radiotherapy. A pulmonary nodule was discovered on computed tomography (CT) conducted for a persistent cough in an 87-year-old male. According to diagnostic imaging, this nodule was clearly delineated and had an irregular margin. The image diagnosis was T1N0M0, stage I primary lung cancer located in the left lower lobe and no pathological type was identified. The patient was treated with SBRT using a Linear accelerator (LINAC) at a total dose of 48 Gray (Gy) in 4 fractions. On performing cone beam CT (CBCT) at the third fraction, the tumor position had moved caudally by about 3 centimeters (cm). For this reason, we canceled further treatment and the case was re-planned. Four days after discontinuing treatment, 4-dimensional CT (4DCT) images were obtained before initiation of the remaining fractions of SBRT. Therefore, the patient completed 4 fractions of SBRT and the tumor location was confirmed before beam delivery. The tumor location differed based on the patient’s position (i.e., standing versus lying in a supine position), and we considered that it moved due to adhesion to the pleura when the patient was standing. If reproducibility of the tumor position cannot be guaranteed, the patient should undergo to CT re-simulation. Oncologists should re-evaluate the movement of the tumor on respiration and adjust the margins accordingly.</div>
SBRT, CBCT, 4-dimensional CT, Re-planning, adhesion, displacement.
913
916
http://ijrr.com/browse.php?a_code=A-10-2055-78&slc_lang=en&sid=1
T.
Rachi
trachi@east.ncc.go.jp
7900319475328460017074
7900319475328460017074
Yes
Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan
N.
Nakamura
7900319475328460017075
7900319475328460017075
No
Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
T.
Akimoto
7900319475328460017076
7900319475328460017076
No
Division of Radiation Oncology and Particle Therapy, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan
R.
Parshuram
7900319475328460017077
7900319475328460017077
No
Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan
K.
Motegi
7900319475328460017078
7900319475328460017078
No
Division of Radiation Oncology and Particle Therapy, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan
T.
Someya
7900319475328460017079
7900319475328460017079
No
Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan