Cardiac-sparing whole lung IMRT in children with lung metastasis

John A. Kalapurakal*, Yunkai Zhang, Alan Kepka, Brian Zawislak, Vythialingam Sathiaseelan, Cynthia Rigsby, Mahesh Gopalakrishnan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Purpose: To demonstrate the dosimetric advantages of cardiac-sparing (CS) intensity modulated radiation therapy (IMRT) in children undergoing whole lung irradiation (WLI). Methods and Materials: Chest CT scans of 22 children who underwent simulation with 3-dimensional (n=10) or 4-dimensional (n=12) techniques were used for this study. Treatment planning was performed using standard anteroposterior-posteroanterior (S-RT) technique and CS-IMRT. Left and right flank fields were added to WLI fields to determine whether CS-IMRT offered any added protection to normal tissues at the junction between these fields. The radiation dose to the lung PTV, cardiac structures, liver, and thyroid were analyzed and compared. Results: CS-IMRT had 4 significant advantages over S-RT: (1) superior cardiac protection (2) superior 4-dimensional lung planning target volume coverage, (3) superior dose uniformity in the lungs with fewer hot spots, and (4) significantly lower dose to the heart when flank RT is administered after WLI. Conclusions: The use of CS-IMRT and 4-dimensional treatment planning has the potential to improve tumor control rates and reduce cardiac toxicity in children receiving WLI.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number3
StatePublished - Mar 1 2013

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


Dive into the research topics of 'Cardiac-sparing whole lung IMRT in children with lung metastasis'. Together they form a unique fingerprint.

Cite this