Mao B, Verma V, Zheng D, Zhu X, Bennion NR, Bhirud AR, Poole MA, Zhen W. Target migration from re-inflation of adjacent atelectasis during lung stereotactic body radiotherapy. World J Clin Oncol 2017; 8(3): 300-304 [PMID: 28638802 DOI: 10.5306/wjco.v8.i3.300]
Corresponding Author of This Article
Weining Zhen, MD, Department of Radiation Oncology, University of Nebraska Medical Center, Ground Floor, Clarkson Tower, Omaha, NE 68198, United States. wzhen@unmc.edu
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jun 10, 2017; 8(3): 300-304 Published online Jun 10, 2017. doi: 10.5306/wjco.v8.i3.300
Target migration from re-inflation of adjacent atelectasis during lung stereotactic body radiotherapy
Bijing Mao, Vivek Verma, Dandan Zheng, Xiaofeng Zhu, Nathan R Bennion, Abhijeet R Bhirud, Maria A Poole, Weining Zhen
Bijing Mao, Department of Oncology, Guizhou Provincial People’s Hospital, Guizhou Province, Guiyang 550002, China
Vivek Verma, Dandan Zheng, Xiaofeng Zhu, Nathan R Bennion, Abhijeet R Bhirud, Maria A Poole, Weining Zhen, Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198, United States
Author contributions: Zhen W conceived of the project; Mao B, Verma V, Zheng D and Poole MA collected data; all authors analyzed data, wrote, and reviewed the paper and provided final approval.
Institutional review board statement: This case report was exempt from the University of Nebraska Medical Center Institutional Review Board and Ethics Committee.
Informed consent statement: Consent to report and publish this case was obtained by the patient’s next of kin.
Conflict-of-interest statement: All authors declare that conflicts of interest do not exist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Weining Zhen, MD, Department of Radiation Oncology, University of Nebraska Medical Center, Ground Floor, Clarkson Tower, Omaha, NE 68198, United States. wzhen@unmc.edu
Telephone: +1-402-5523844 Fax: +1-402-5523013
Received: December 4, 2016 Peer-review started: December 5, 2016 First decision: February 21, 2017 Revised: March 3, 2017 Accepted: April 18, 2017 Article in press: April 20, 2017 Published online: June 10, 2017 Processing time: 179 Days and 19.8 Hours
Abstract
Stereotactic body radiotherapy (SBRT) is a widely accepted option for the treatment of medically inoperable early-stage non-small cell lung cancer (NSCLC). Herein, we highlight the importance of interfraction image guidance during SBRT. We describe a case of early-stage NSCLC associated with segmental atelectasis that translocated 15 mm anteroinferiorly due to re-expansion of the adjacent segmental atelectasis following the first fraction. The case exemplifies the importance of cross-sectional image-guided radiotherapy that shows the intended target, as opposed to aligning based on rigid anatomy alone, especially in cases associated with potentially “volatile” anatomic areas.
Core tip: This is a case of early-stage non-small cell lung cancer associated with segmental atelectasis that translocated owing to re-expansion of the adjacent segmental atelectasis following the first fraction. There are image-guidance systems that register solely based on rigid (bony) anatomy and others that also show soft tissue; if the former would have been used, the translocated target would have been missed. The case exemplifies the importance of cross-sectional image-guided radiotherapy that shows the intended target, as opposed to aligning based on rigid anatomy alone, in cases associated with potentially “volatile” anatomic areas.
