01 - S502 I. J. Radiation Oncology d Biology d Physics...

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2538 Hemithoracic Radiotherapy After Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma: A Tale of Two Techniques C. E. Hill-Kayser, S. Avery, P. James, C. F. Mesina, J. S. Friedberg, L. L. Lin, S. M. Hahn, R. Rengan Hospital of the University of Pennsylvania, Philadelphia, PA Background: Death in patients with malignant pleural mesothelioma (MPM) is most often caused by local disease progression, and aggressive local treatment with extrapleural pneumonectomy (EPP) and adjuvant radiotherapy (RT) has been utilized by some centers. Recently, signi±cant mortality rates have been reported due to radiation pneumonitis, felt to be related to contralateral lung (CL) dose (Allen, 2006). Two approaches have been described for delivery of adjuvant hemithoracic RT, the ±rst employing opposed anterior-posterior photon beams with electron supplementation (EPT) (Yajnik, 2003), and the second using intensity mod- ulated radiation therapy (IMRT) (Ahamad, 2003). We performed a dosimetric comparison of these two RT techniques, evaluating dose delivery to the ipsilateral hemithorax, as well as the CL and surrounding structures. Materials/Methods: Treatment plans of 8 MPM patients (4 left-sided, 4 right-sided) who underwent EPP and hemithoracic IMRT at the Hospital of the University of Pennsylvania were analyzed. The prescribed planned target volume (PTV) dose was 45 Gray (Gy). Standard PTV optimization and normal tissue constraints were used, with additional constraints such that volume of CL receiving 5 Gy (V5) was limited to 60%, and mean CL dose to 9 Gy. EPT plans to deliver 54 Gy for these 8 patients were then
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This note was uploaded on 05/24/2010 for the course MD 23 taught by Professor Tarc during the Spring '10 term at Anadolu University.

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