Assessment of intrafractional motion in lung SBRT treatment

Authors

  • Valquiria Guimarães Pereir UERJ
  • Saulo Santos Fortes
  • Carolina Seixas Dubeux

DOI:

https://doi.org/10.29384/rbfm.2025.v19.19849001787

Keywords:

medical physics, radiotherapy, lung SBRT, cone beam-CT

Abstract

The global impact of cancer on public health is alarming, leading to a significant increase in incidence and mortality, including in Brazil, where an increase to approximately 704 thousand new cases between 2023 and 2025 is projected. Lung cancer is one of the most common forms of the disease, affecting both men and women. Radiotherapy plays a crucial role in the treatment of lung cancer, harnessing technological advancements to improve precision and minimize side effects. The technique of Stereotactic Body Radiotherapy (SBRT) has emerged as an effective approach, especially for patients who are not candidates for surgery. However, respiratory motion can compromise the accuracy of radiation delivery, requiring the use of respiratory management techniques and 4DCT imaging to ensure treatment accuracy. Cone-Beam Computed Tomography (CBCT) plays a fundamental role in error correction during the treatment process. At the National Cancer Institute (INCA), SBRT has been applied since 2014, with rigorous verification protocols before each radiotherapy session. Recent studies have focused on intrafraction target motion during lung SBRT, aiming to enhance treatment effectiveness and reduce adverse effects. A prospective analysis of the total treatment time of six patients undergoing lung SBRT highlighted the importance of immobility during the procedure. The results revealed small patient displacements, which did not have a significant impact on dose distribution, as the displacements were within the adopted margin and without radiation dosimetric impairments. Although the current 5 mm PTV margin used at INCA is considered appropriate, further research is needed to determine whether a reduction of this margin can further improve outcomes for patients.

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Published

2025-02-27

How to Cite

Guimarães Pereir, V., Santos Fortes, S., & Seixas Dubeux, C. (2025). Assessment of intrafractional motion in lung SBRT treatment. Brazilian Journal of Medical Physics, 19, 787. https://doi.org/10.29384/rbfm.2025.v19.19849001787

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Section

Artigo Original