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Med Phys. 2017 Jun;44(6):2595-2612. doi: 10.1002/mp.12227. Epub 2017 Apr 20.

Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology.

Author information

1
Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC CancerCenter, Pittsburgh, PA, 15232, USA.
2
Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, 48202, USA.
3
Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
4
Imaging and Radiation Oncology Core (IROC), University of Pennsylvania, Philadelphia, PA, 19104, USA.

Abstract

The efficacy of stereotactic body radiotherapy (SBRT) has been well demonstrated. However, it presents unique challenges for accurate planning and delivery especially in the lungs and upper abdomen where respiratory motion can be significantly confounding accurate targeting and avoidance of normal tissues. In this paper, we review the current literature on SBRT for lung and upper abdominal tumors with particular emphasis on addressing respiratory motion and its affects. We provide recommendations on strategies to manage motion for different, patient-specific situations. Some of the recommendations will potentially be adopted to guide clinical trial protocols.

KEYWORDS:

4D; SBRT; abdomen; gating; lung; respiratory motion; stereotactic body radiotherapy

PMID:
28317123
PMCID:
PMC5473359
DOI:
10.1002/mp.12227
[Indexed for MEDLINE]
Free PMC Article

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