08 Sep

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: The opposite view in the discussion over lung toxicity

The opposite view in the discussion over lung toxicity holds that the lung volume receiving 60 to 80% of the tumor target dose relative to the total lung volume results in the morbidity and potential long-term complications of radiotherapy. According to this argument, preserving the maximum lung volume to receive doses <50% of the tumor […]

08 Apr

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Discussion

To test the potential use of MnSOD gene therapy in vivo, an experimental model was developed in which 75 μL plasmid-liposome complex was injected intratracheally into anesthetized C57BL/6J mice. Mice received MnSOD plasmid-liposome, control β-gal (marker gene) plasmid-liposome, or no injection. Mice were then irradiated to either 2,000 or 3,000 cGy in a single fraction […]

06 Apr

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Development of Experimental Inhalation Gene Therapy for Lung Radioprotection

The optimization of conformal radiotherapy and the eventual development of techniques that move the patient and treatment machine during radiotherapy will further improve dose distribution and the therapeutic ratio. However, even the use of intracavitary or interstitial radiation delivery systems cannot prevent exposure of significant volumes of the lung to ionizing radiation. For this reason, […]

02 Apr

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Discussion of normal lung radiation biology

There continues to be theoretical discussion of normal lung radiation biology in the clinic. Here, opposing views suggest an advantage to either eliminating some normal lung volume from all radiation exposure, or spreading out the target volume dose to the greatest total volume of lung possible. If a patient’s tumor volume in the right hilar […]

31 Mar

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Development of a Conformed Five-Field Radiation Therapy Program to Maximum Therapeutic Ratio During Conventional Fractionation

Multiple-field radiotherapy (confirmed radiotherapy) programs have been used to treat lung cancer patients at several treatment centers. There has been some individual variation among centers in the number of fields treated per day. For example, the term “conformal radiotherapy” has been used to describe treatment of patients receiving two fields per day (anterior and posterior), […]

29 Mar

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Results

Development of Conformal Multiple-Field Radiation Therapy for Lung Cancer Techniques to improve the therapeutic ratio for radiotherapy of target volumes in the chest have relied primarily on three strategies: alteration and fractionation, alteration in total dose delivered, and improvements in tumor target volume definition. The historical development of treatment strategies prior to 1993 is shown […]

27 Mar

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Development of Experimental Inhalation Gene Therapy for Lung Radioprotection

Mouse Intratracheal Injections of Plasmid/Liposome Complexes. The pRK5-MnSOD plasmid (10 mg/mL) was mixed at a ratio of 500 μg (50 μL) DNA with 26 (μg lipofectant (1 μg/μL) for each injected C57BL/6J mouse (Jackson Laboratories; Bar Harbor, Maine). Following intraperitoneal injection of pentobarbital sodium (Nembutal) anesthesia (Abbott Laboratories; North Chicago, 111), 1.25 mg, each C57BL/6J […]

25 Mar

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Development of Conformal Five-Field Radiation Therapy for NSCLC

During beams-eye-view planning, the actual isocenter of the treatment plan was set at the tumor volumetric centroid. By use of our software visualization algorithm, each beam portal was then automatically tailored to a chosen photon beam incidence angle relative to the patient. To minimize areas of beam overlap in normal lung, a minimum 30° hinge […]

23 Mar

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer: Materials and Methods

Development of Conformal Five-Field Radiation Therapy for NSCLC Following a diagnostic CT scan study, a preplanning film localization was carried out to establish the radiographic borders of treatment. During this short initial localization simulation, the isocenter was placed closest to the center of the tumor and skin marks were drawn on the patient for laser […]

21 Mar

Considerations in Optimizing Radiation Therapy for Non-small Cell Lung Cancer

Despite the availability of modern megavoltage linear accelerators, sophisticated three-dimensional treatment planning software, helical CT scan devices, and multileaf collimation radiotherapy beams, the ability of radiation therapy to provide long-term local control of stages IIB to III non-small cell lung cancer (NSCLC) has been disappointing. Around one third of patients irradiated for unresectable disease have […]

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