Open Access

4‑Dimensional computed tomography analysis of clinical target volume displacement in adjuvant radiation of patients with gastric cancer and its implication on radiotherapy

  • Authors:
    • Jin Peng
    • Jun Gong
    • Xiaoyong Wang
    • Jingjing Mou
    • Hui Xu
    • Jing Dai
    • Fuxiang Zhou
    • Yunfeng Zhou
  • View Affiliations

  • Published online on: February 13, 2019     https://doi.org/10.3892/ol.2019.10037
  • Pages: 3641-3648
  • Copyright: © Peng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The present study aimed to accurately measure the displacement magnitude of the radiotherapy subsite target due to respiration, and to evaluate its implication on 4‑dimensional computed tomography (4D‑CT) in adjuvant radiation of gastric cancer. To investigate this, 10 patients with gastric cancer receiving adjuvant radiotherapy were enrolled. 4D‑CT scans were performed on all patients and respiratory signals were recorded simultaneously. The clinical target volume (CTV) and 7 regions of interest (ROIs) were delineated in all phases of the CT imaging. The displacements of all ROIs in the cephalic‑caudal, anterior‑posterior and left‑right directions were measured and analyzed. Two sets of plans based on planning target volume 3D (PTV3D) and PTV4D, were generated for each patient and PTV3Dcal was calculated by expanding the non‑uniform margin on CTV3D according to the displacement analysis data. The dosimetric parameters and target volumes of the 3 radiotherapy treatment plans were compared. The displacement of the various ROIs varied widely. The mean PTV4D was smaller than the PTV3D and PTV3Dcal. Compared with Plan3D, Plan4D reduced the mean dose of radiation to the liver and left kidney by 23.2 and 43.5%, respectively. The liver volume receiving ≥30 Gy and the left kidney volume receiving ≥20 Gy were decreased by 10.8 and 29.7%, respectively. No differences were observed in the PTV coverage and protection of organs at risk (OARs) between Plan3Dcal and Plan4D. In conclusion, the breathing‑induced displacement patterns of the subsite targets in patients with gastric cancer vary. The individualized CTV margins of expansion based on 4D‑CT lead to a decrease PTV and radiation dose to OARs. The non‑uniform margins in various directions should be considered as areas for further investigation.
View Figures
View References

Related Articles

Journal Cover

April-2019
Volume 17 Issue 4

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
x
Spandidos Publications style
Peng J, Gong J, Wang X, Mou J, Xu H, Dai J, Zhou F and Zhou Y: 4‑Dimensional computed tomography analysis of clinical target volume displacement in adjuvant radiation of patients with gastric cancer and its implication on radiotherapy. Oncol Lett 17: 3641-3648, 2019
APA
Peng, J., Gong, J., Wang, X., Mou, J., Xu, H., Dai, J. ... Zhou, Y. (2019). 4‑Dimensional computed tomography analysis of clinical target volume displacement in adjuvant radiation of patients with gastric cancer and its implication on radiotherapy. Oncology Letters, 17, 3641-3648. https://doi.org/10.3892/ol.2019.10037
MLA
Peng, J., Gong, J., Wang, X., Mou, J., Xu, H., Dai, J., Zhou, F., Zhou, Y."4‑Dimensional computed tomography analysis of clinical target volume displacement in adjuvant radiation of patients with gastric cancer and its implication on radiotherapy". Oncology Letters 17.4 (2019): 3641-3648.
Chicago
Peng, J., Gong, J., Wang, X., Mou, J., Xu, H., Dai, J., Zhou, F., Zhou, Y."4‑Dimensional computed tomography analysis of clinical target volume displacement in adjuvant radiation of patients with gastric cancer and its implication on radiotherapy". Oncology Letters 17, no. 4 (2019): 3641-3648. https://doi.org/10.3892/ol.2019.10037