Dosimetric comparison of stereotactic body radiotherapy in different respiration conditions: a modeling study

Kristina Kontrisova, Markus Stock, Karin Dieckmann, Joachim Bogner, Richard Pötter, Dietmar Georg

Research output: Journal article (peer-reviewed)Journal article

30 Citations (Scopus)


PURPOSE: To evaluate the dosimetric consequences for irradiated lung tissue for different respiration conditions for hypofractionated stereotactic body radiotherapy (SBRT).

METHODS AND MATERIALS: Thirteen patients with lung lesion undergoing SBRT treatment in shallow breathing with abdominal compression (SB+AP) underwent additional multislice CT studies in free breathing (FB), deep inspiration and expiration breath hold (DIBH, DEBH). For each patient 6 different treatment plans were designed for the various respiration conditions applying standard (7/7/10 mm), reduced (5/5/5 mm) and individual margins. The FB plan with standard margins was used as a reference. The percentage of volume of the ipsilateral lung receiving total doses > or=12, 15> or= and > or=18 Gy, mean lung dose (D(mean)), NTCP corrected for fractionation effects and the total monitor units (MU) were evaluated.

RESULTS: With DIBH it was possible to reduce all lung dose parameters by about 20%. Applying reduced margins in DIBH, this reduction was even increased to about 40%. The standard technique (SB+AP) with individual margins showed similar results as DIBH with standard margins. DEBH showed some improvement over FB only when reduced margins were applied. Only for 5/13 patients NTCP values >1% were obtained. For these patients a significant NTCP reduction was achieved with DIBH techniques.

CONCLUSIONS: In SBRT shallow breathing with abdominal compression produces acceptable results concerning lung DVHs. DIBH, especially with reduced margins, showed the best lung sparing. For the clinical implementation of such a technique some form of gating is advisable. However, there are some practical limitations due to high fractional doses.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - Oct 2006
Externally publishedYes


  • Adult
  • Aged
  • Aged, 80 and over
  • Dose Fractionation, Radiation
  • Humans
  • Linear Models
  • Lung/diagnostic imaging
  • Lung Neoplasms/diagnostic imaging
  • Middle Aged
  • Radiation Dosage
  • Radiometry/methods
  • Radiosurgery/methods
  • Respiration
  • Tomography, X-Ray Computed/methods
  • Breath hold
  • Lung cancer
  • Stereotactic irradiation
  • Hypofractionation
  • Body frame

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology, Nuclear Medicine and Imaging


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