Relationship Between Diseased Lung Tissues on Computed Tomography and Motion of Fiducial Marker Near Lung Cancer
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概要
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BACKGROUND: For lung cancer patients with poor pulmonary function due to emphysema or fibrosis, it is important to predict the amplitude of internal tumor motion to minimize the irradiation of the functioning lung tissue before receiving stereotactic body radiotherapy. MATERIALS AND METHODS: Two board-certified diagnostic radiologists independently assessed the degree of pulmonary emphysema and fibrosis on computed tomography (CT) in 71 patients with peripheral lung tumors before real-time tumor-tracking radiotherapy (RTRT). The relationships between CT findings of the lung parenchyma and the motion of the fiducial marker near the lung tumor were investigated. Thirty patients had normal pulmonary function. Twenty-nine patients had obstructive pulmonary dysfunction (FEV1/FVC < 70%), 6 patients had constrictive dysfunction (%VC < 80%), and 16 had mixed dysfunction. RESULTS: The upper region was associated with smaller tumor motion, as expected (p=0.0004), and presence of fibrosis (p=0.088) and pleural contact of the tumor (p=0.086) were weakly associated with the tumor motion. The presence of fibrotic change in lung tissue was associated with smaller tumor motion in the upper region (p<0.05) but not in the lower region. The findings of emphysema and pulmonary function tests were not associated with tumor motion. CONCLUSIONS: Tumors in the upper region of lungs with fibrotic changes have smaller motion than those in the upper region of lungs without fibrotic changes. Tumor motion in the lower lung region was not significantly different between patients with and those without lung fibrosis. Emphysema was not associated with the amplitude of tumor motion.
- 2011-04-01
著者
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Oizumi S
First Department Of Medicine Hokkaido University School Of Medicine
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Oizumi Satoshi
北海道大学 医学部第一内科学
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Oizumi Satoshi
First Department Of Medicine Hokkaido University School Of Medicine
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Nishimura M
First Department Of Medicine Hokkaido University School Of Medicine
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Nakashima M
Department Of Molecular Immunology And Clinical Immunology Medical Institute Of Bioregulation Kyushu
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Sugiura Hiroshi
Department Of Surgical Oncology Division Of Cancer Medicine Hokkaido University Graduate School Of M
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Nakashima M
Kyushu Univ. Fukuoka Jpn
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Yamazaki Koichi
First Department Of Medicine Hokkaido University School Of Medicine
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Shirato Hiroki
Keiyukai Sapporo Hospital Sapporo Jpn
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Onimaru Rikiya
Division Of Radiation Oncology Department Of Radiology Hokkaido University School Of Medicine
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Fujima Noriyuki
Department Of Radiology Hokkaido University Hospital
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Terae Satoshi
Department Of Diagnostic And Interventional Radiology Hokkaido University Hospital
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Sugimori Hiroyuki
Department Of Diagnostic And Interventional Radiology Hokkaido University Hospital
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Haba Shin
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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