Keywords:
Cancer, Radiation therapy / Oncology, PET-CT, CT, Nuclear medicine, Lung
Authors:
S. L. Kure1, M. Petersen2, T. Hansen 3; 1Tjæreborg/DK, 2Esbjerg Ø/DK, 3Vejle /DK
DOI:
10.26044/ecr2019/C-2863
Conclusion
The use of fused PET/CT for radiotheraphy planning will affect the given dose to both target and OAR.
Common to the included studies is,
that PET/CT plays an essential role in the outcome for the patients treatment effect and side effects.
However,
the studies show prominent advantages and disadvantages,
meaning that the definition of the best result depends on the focus If the goal is to get the biggest dose escalation,
study two has the best results.
If the goal is the smallest PTV,
the method from study seven is best.
If the goal is a minimum dose to the OAR and fewer side effects to the patients,
the method from study four should be used.
The increased dose will often result in serious side effect and lower survival rate,
especially in cases with fewer dose restrictions.
The used methods could profitably be optimized by lowering the escalated dose to a reasonable level or using adaptive strategies to take changes in the the tumor volume into account.
This way it might be possible to intensify the radiotherapy,
without incresing the amount of side effect to the patient.
Therefore the higher the dose,
and therefore the more effective the treatment is,
the more beneficial replanning is to the patients to avoid a higher risk of severe side effects.
The results show that the higher sensitivity of the PET/CT scan,
is advantageous compared to the CT when planning the radiotherapy.
The study also shows great potential for further research and clinical trials,
beacuse the results feasibility of the combination of strategies to improve the treatment.