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Abstract
Background: This study aimed to analyze differential radiotherapy (RT) responses according to the pathological type of lung cancer to see the possibility of applying adaptive radiotherapy (ART).

Methods: ART planning with resampled-computed tomography was conducted for a total of 30 patients (20 non-small-cell lung cancer patients and 10 small-cell lung cancer patients) using a deformable image registration technique to reveal gross tumor volume (GTV) changes according to the duration of RT.

Results: The small-cell lung cancer group demonstrated an average GTV reduction of 20.95% after the first week of initial treatment (p = 0.001), whereas the adenocarcinoma and squamous cell carcinoma groups showed an average volume reduction of 20.47% (p = 0.015) and 12.68% in the second week. The application of ART according to the timing of GTV reduction has been shown to affect changes in radiation dose irradiated to normal tissues. This suggests that ART applications may have to be different depending on pathological differences in lung cancer.

Conclusion: Through these results, the present study proposes the possibility of personalized treatment options for individual patients by individualizing ART based on specific radiation responses by pathologic types of lung cancer.

Affiliations

Woo Chul Kim 1 2, Yong Kyun Won 2, Sang Mi Lee 3, Nam Hun Heo 4, Seung-Gu Yeo 5, Ah Ram Chang 6, Sun Hyun Bae 5, Jae Sik Kim 6, Ik Dong Yoo 3, Sun-Pyo Hong 3, Chul Kee Min 1 2, In Young Jo 2, Eun Seog Kim 2
1Department of Radiation Oncology, Division of Medical Physics, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea.
2Department of Radiation Oncology, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea.
3Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea.
4Clinical Trial Center, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea.
5Department of Radiation Oncology, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Bucheon 14584, Republic of Korea.
6Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea.