Respiratory motion management for external radiotherapy treatment

Area of Science:

• Oncological Radiotherapy
• Medical Physics
• Radiation Oncology

Background:

• Respiratory motion significantly impacts external beam radiation therapy accuracy.
• Hypofractionated and stereotactic treatments necessitate precise motion management due to reduced safety margins.
• Established guidelines, like ICRU report 62, highlight the growing importance of motion management.

Purpose of the Study:

• To update recommendations for respiratory motion management in external radiotherapy.
• To provide current insights into motion amplitudes and margin definitions for various organs.
• To review and present updated strategies and technological solutions for managing moving targets.

Main Methods:

• Review of motion amplitudes for different organs.
• Definition of margins in radiotherapy.
• Updated review of motion management strategies and technological solutions.
• Case examples of motion management in abdominal, thoracic, and hepatic locations.

Main Results:

• Provides updated data on organ motion amplitudes.
• Defines current margin recommendations for radiotherapy.
• Details various motion management strategies and associated technologies.
• Illustrates practical application in specific treatment sites.

Conclusions:

• Effective respiratory motion management is crucial for modern radiotherapy, especially with hypofractionation.
• Updated guidelines and technological advancements improve the precision of treating moving targets.
• Implementation details for abdominal, thoracic, and hepatic treatments are provided for clinical practice.