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14 - S460 I J Radiation Oncology d Biology d Physics Volume...

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2650 Radiotherapy Treatment Planning for Patients with Malignant Pleural Mesothelioma (MPM) using 18-FDG Positron Emission Tomography (PET) E. D. Yorke, B. Laser, L. M. Krug, R. Flores, S. Nehmeh, Y. Erdi, E. Stechel, V. Rusch, K. E. Rosenzweig Memorial Sloan-Kettering Cancer Center, New York, NY Purpose/Objective(s): The treatment of MPM after pleurectomy/decortication (P/D) remains a therapeutic challenge. A recent report showed poor local control and long term survival with traditional mixed photon/electron treatment. Tumor delineation in these situations is also challenging due to the difficulty in distinguishing tumor from non-malignant radiographic abnormalities. Therefore, we have incorporated registered 18-FDG -PET scans as part of the treatment planning process. This study reports on changes in treatment volumes with the use of the PET images. Materials/Methods: Eleven patients with malignant pleural mesothelioma who underwent pleurectomy/decortication or were un- resectable were enrolled in a prospective IRB-approved feasibility study. These patients were not candidates for extrapleural pneu- monectomy due to impaired pulmonary function or extent of tumor. An 18-FDG-PET was performed at the time of simulation in the treatment position and registered with the treatment planning CT to aid in tumor delineation. Two planning target volumes (PTV) were delineated: a CT-only PTV and a CT/PET PTV. All treatment plans were with intensity modulated radiation therapy.
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