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Table 4 Comparison of absolute dose between gating and ITV-based plans to (a) Spinal Cord, (b) Heart, (c) Ribs, (d) Esophagus, (e) Bronchial Tree, and (f) Trachea for each fractionation scheme. Clinical endpoints are listed for each organ as well as dose limits taken from RTOG 0915 and TG101 for 4 × 12 Gy and 3 × 18 Gy fractionation regimens, respectively

From: To gate or not to gate - dosimetric evaluation comparing Gated vs. ITV-based methodologies in stereotactic ablative body radiotherapy (SABR) treatment of lung cancer

(a)

Dmax to Volume = 0.35 cc (Gy)

Dmax (Gy)

Spinal Cord: Myelitis

Limit

Gating

ITV

Difference

Limit

Gating

ITV

Difference

4 × 12 Gy

20.8

9.03 ± 4.27 (2.2, 20.9)

9.30 ± 4.36 (1.9, 21.3)

0.49 ± 2.28 (−7.7, 10.5)

26

10.60 ± 4.93 (2.4, 25.1)

10.84 ± 5.00 (2.1, 25.7)

0.48 ± 2.79 (−10.1, 11.5)

3 × 18 Gy

18

9.88 ± 4.71 (2.3, 22.4)

10.28 ± 4.74 (1.8, 23.1)

0.55 ± 2.69 (−8.6, 10.4)

21.9

11.63 ± 5.49 (2.6, 28.0)

12.08 ± 5.44 (2.2, 26.5)

0.64 ± 3.24 (−11.4,10.9)

(b)

Dmax to Volume = 15 cc (Gy)

Dmax (Gy)

Heart: Pericarditis

Limit

Gating

ITV

Difference

Limit

Gating

ITV

Difference

4 × 12 Gy

28

8.49 ± 8.08 (0.2, 35.8)

8.83 ± 4.40 (0.2, 31.7)

0.46 ± 2.11 (−7.7, 6.2)

34

15.93 ± 14.86 (0.2, 55.2)

16.06 ± 13.55 (0.2, 52.4)

0.37 ± 4.00 (−15.9, 12.7)

3 × 18 Gy

24

9.39 ± 8.80 (0.2, 36.2)

9.69 ± 8.01 (0.2, 35.4)

0.29 ± 2.59 (−10.4, 7.1)

30

17.95 ± 16.39 (0.2, 62.3)

17.81 ± 14.86 (0.2, 57.6)

−0.14 ± 5.13 (−16.8, 14.2)

(c)

Dmax to Volume = 1 cc (Gy)

Dmax (Gy)

Ribs: Fracture

Limit

Gating

ITV

Difference

Limit

Gating

ITV

Difference

4 × 12 Gy

32

42.12 ± 9.97 (19.3, 55.1)

42.26 ± 9.70 (20.5, 57.0)

0.14 ± 4.19 (−7.3, 17.2)

40

49.83 ± 6.96 (21.3, 59.0)

49.38 ± 3.79 (26.4, 58.7)

−0.45 ± 3.12 (−11.0, 7.5)

3 × 18 Gy

28.8

47.80 ± 11.45 (21.4, 61.8)

46.65 ± 10.75 (23.1, 64.1)

−1.15 ± 4.88 (−11.1, 15.4)

36.9

55.98 ± 8.72 (23.6, 66.8)

54.97 ± 7.71 (29.9, 66.1)

−1.01 ± 3.61 (−10.8, 10.4)

(d)

Dmax to Volume = 5 cc (Gy)

Dmax (Gy)

Esophagus: Stenosis

Limit

Gating

ITV

Difference

Limit

Gating

ITV

Difference

4 × 12 Gy

18.8

5.91 ± 4.83 (0.3, 21.5)

6.45 ± 4.68 (0.4, 17.8)

0.54 ± 1.95 (−6.3, 8.4)

30

11.96 ± 9.36 (0.6, 48.1)

12.48 ± 7.99 (0.6, 35.3)

0.53 ± 3.97 (−14.6, 16.3)

3 × 18 Gy

17.7

6.59 ± 5.35 (0.4, 24.2)

7.08 ± 5.10 (0.4, 19.8)

0.49 ± 2.26 (−7.6, 9.1)

25.2

13.55 ± 10.32 (0.7, 52.8)

13.85 ± 8.42 (0.7, 35.7)

0.30 ± 4.53 (−17.3, 13.8)

(e)

Dmax to Volume = 4 cc (Gy)

Dmax (Gy)

Bronchial Tree: Stenosis

Limit

Gating

ITV

Difference

Limit

Gating

ITV

Difference

4 × 12 Gy

15.6

9.52 ± 9.46 (0.8, 34.8)

8.54 ± 7.30 (0.8, 24.3)

−0.99 ± 2.97 (−10.5, 1.5)

34.8

25.95 ± 16.63 (8.5, 54.4)

24.37 ± 13.92 (10.0, 52.0)

−1.58 ± 4.65 (−14.4, 2.4)

3 × 18 Gy

15

11.02 ± 10.86 (0.9, 38.6)

9.19 ± 7.53 (0.9, 25.4)

−1.83 ± 3.98 (−13.2, 1.9)

30

29.08 ± 18.76 (8.3, 58.7)

26.39 ± 15.23 (10.9, 58.5)

−2.69 ± 6.09 (−16.8, 3.9)

(f)

Dmax to Volume = 4 cc (Gy)

Dmax (Gy)

Trachea: Stenosis

Limit

Gating

ITV

Difference

Limit

Gating

ITV

Difference

4 × 12 Gy

15.6

1.07 ± 1.79 (0.1, 4.3)

1.29 ± 1.89 (0.1, 4.6)

0.22 ± 0.31 (0.0, 0.7)

34.8

2.47 ± 2.96 (0.1, 6.20)

2.73 ± 2.89 (0.1, 6.3)

0.26 ± 0.44 (0.0, 1.0)

3 × 18 Gy

15

1.27 ± 2.16 (0.1, 5.1)

1.50 ± 2.27 (0.1, 5.5)

0.24 ± 0.33 (0.0, 0.7)

30

3.01 ± 3.72 (0.1, 8.1)

3.28 ± 3.66 (0.1, 8.3)

0.28 ± 0.45 (0.0, 1.1)