Positron emission tomography-computed tomography guided radiotheraphy planning in lung cancer

Aims and background: In three dimensional conformal radiotherapy (3D-CRT), treatment planning is based on computerized tomography (CT) images. However, the data obtained from CT may not be sufficient in target delination. The purpose of this study is to show the differences between the radiotherapy (RT) plans which were done with positron emission tomography (PET) fusion or not. Methods: Patients with lung cancer between February 2009 and January 2012 at our institution were assessed retrospectively. Sixty patients who were treated with 3DCRT, CT simulation images were registrated with PET images. For each patient target volumes were determined and normal tissues were revised. Wilcoxon Signed Rank Test was used to compare the two groups. Results: For gross tumor volume (GTV), clinical target volume (CTV) and planning target volume (PTV); median volume values, median mean dose values and median maximum dose values were significantly different according to use of PET. About normal tissue doses; mean lung dose (MLD), lung V20, mean and maximum esophagus dose, V50 and V60, mean heart dose and maximum medulla spinalis dose were analyzed. Conclusion: Within these parameters there were statistically significant difference except in maximum dose of esophagus and V60. In our study, we observed decreased target volumes and higher dose distrubutions for target volumes in PET registrated RT plans. According to these data, it is possible to say that optimal RT plans can be formed for lung cancer by using PET registration.