@article{oai:repo.qst.go.jp:00045886,
 author = {Jingu, Keiichi and Ariga, Hisanori and Kaneta, Tomohiro and Takai, Yoshihiro and Takeda, Ken and Narazaki, Kakutarou and Metoki, Takahiro and Fujimoto, Keisuke and Umezawa, Rei and Ogawa, Yoshihiro and Nemoto, Kenji and Koto, Masashi and Mitsuya, Masatoshi and Matsufuji, Naruhiro and Takahashi, Shoki and Yamada, Syougo and et.al and 神宮 啓一 and 有賀 久哲 and 高井 良尋 and 武田 賢 and 小川 芳弘 and 根本 建二 and 小藤 昌志 and 松藤 成弘 and 山田 章吾},
 issue = {127},
 journal = {BMC Cancer (Online only:URL:http://www.biomedcentral.com/bmccancer)},
 month = {Apr},
 note = {Background
To evaluate the safety of focal dose escalation to regions with standardized uptake value (SUV) >2.0 using intensity-modulated radiation therapy (IMRT) by comparison of radiotherapy plans using dose-volume histograms (DVHs) and normal tissue complication probability (NTCP) for postoperative local recurrent rectal cancer
\nMethods
First, we performed conventional radiotherapy with 40 Gy/20 fr. (CRT 40 Gy) for 12 patients with postoperative local recurrent rectal cancer, and then we performed FDG-PET/CT radiotherapy planning for those patients. We defined the regions with SUV > 2.0 as biological target volume (BTV) and made three boost plans for each patient: 1) CRT boost plan, 2) IMRT without dose-painting boost plan, and 3) IMRT with dose-painting boost plan. The total boost dose was 20 Gy. In IMRT with dose-painting boost plan, we increased the dose for BTV+5 mm by 30% of the prescribed dose. We added CRT boost plan to CRT 40 Gy (summed plan 1), IMRT without dose-painting boost plan to CRT 40 Gy (summed plan 2) and IMRT with dose-painting boost plan to CRT 40 Gy (summed plan 3), and we compared those plans using DVHs and NTCP.
\nResults
Dmean of PTV-PET and that of PTV-CT were 26.5 Gy and 21.3 Gy, respectively. V50 of small bowel PRV in summed plan 1 was significantly higher than those in other plans ((summed plan 1 vs. summed plan 2 vs. summed plan 3: 47.11 +/- 45.33 cm3 vs. 40.63 +/- 39.13 cm3 vs. 41.25 +/- 39.96 cm3(p < 0.01, respectively)). There were no significant differences in V30, V40, V60, Dmean or NTCP of small bowel PRV.
\nConclusions
FDG-PET-guided IMRT can facilitate focal dose-escalation to regions with SUV above 2.0 for postoperative local recurrent rectal cancer.},
 pages = {127-1--127-10},
 title = {Focal dose escalation using FDG-PET-guided intensity-modulated radiation therapy boost for postoperative local recurrent rectal cancer: a planning study with comparison of DVH and NTCP},
 volume = {10},
 year = {2010}
}