Additional file 2: Table S1. of Comparison of photon volumetric modulated arc therapy, intensity-modulated proton therapy, and intensity-modulated carbon ion therapy for delivery of hypo-fractionated thoracic radiotherapy

Normal lung dose distribution. Table S2. Dose distribution for the heart and the esophagus. Table S3. Recalculated 4D (doses accumulated from 4D CT phases within the gating window) vs. 3D dose comparison for selected dose parameters for intensity modulated a) carbon ion therapy, and b) proton therapy with the Wilcoxon rank test. (DOC 114 kb

Definitive Upfront Stereotactic Ablative Radiotherapy Combined with Image-Guided, Intensity Modulated Radiotherapy (IG-IMRT) or IG-IMRT Alone for Locally Advanced Non-Small Cell Lung Cancer - Fig 2

<p>The a) overall survival (OS), and b) progression-free survival (PFS) for all patients. The c) local, d) regional, and e) distant control for patients who were treated with SABR ± IG-IMRT. f) Local control following SABR + IG-IMRT vs. that in patients with T_x, T1/2 or T3/4 disease who received IG-IMRT.</p

Illustration of a composite treatment plan for a patient with oligo-metastatic poorly differentiated squamous cell carcinoma (cT1a, N3, M1b).

<p>She received upfront carboplatin/gemcitabine with excellent extra-thoracic response. Subsequently, SABR to her primary disease + IG-IMRT to her regional disease as the only remaining disease following chemotherapy were administered. She remains disease free 2 years after the completion of all treatments.</p

Maximum dose to the organs at risk (including organs immediately adjacent to the tumor).

<p>Std. Dev.: standard deviation. Central: central lesions for which all the dose constraints were met. Central_no: central lesions for which ≥1 dose constraints were not met. Peripheral: peripheral lesions. Gy: gray.</p

Dose constraints for the prescription dose of 70 Gy delivered in 10 fractions.

*<p>30 Gy acceptable in selected cases.</p>†<p>Total lung volume = total volume of both lungs minus that of the GTV.</p><p>V₂₀ is the % of the volume receiving 20 Gy. MLD: mean lung dose.</p

Dose Coverage of the PTV for the three groups of lung lesions.

<p>PTV: planning target volume. OARs: Organs at risk. D₉₅: dose covering 95% of the PTV; %PTV_{70 Gy}: percentage of the PTV volume receiving 70 Gy; PTV_max: maximum dose to the PTV. Std. Dev.: standard deviation; Central: central lesions for which all the dose constraints were met; Central_no: central lesions for which ≥1 dose constraints were not met; Peripheral: peripheral lesions.</p

Comparison of the tumor characteristics of the Central_no group of lesions with the Central and Peripheral groups of lesions.

<p>Central+Peripheral: central and peripheral lesions for which all the dose constraints were met. Central_no: central lesions for which ≥1 dose constraints were not met. Std. dev.: standard deviation. GTV: gross tumor volume. PTC: planning target volume. #: number. cm: centimeter. cc: cubic centimeter. OARs: organs at risk.</p

Dose parameters for the normal lung tissue.

<p>Std. Dev.: standard deviation. Central: central lesions for which all the dose constraints were met. Central_no: central lesions for which ≥1 dose constraints were not met. Peripheral: peripheral lesions. V₅, V₁₀, and V₂₀: percentage of volume receiving 5, 10, and 20 Gy, respectively. MLD: mean lung dose.</p

Grade 5 toxicity reported in the literature following stereotactic body radiotherapy for centrally located lung cancer.

†<p>Fr: fractions;</p>*<p>previously irradiated patients.</p

Illustration of a comparison of the 2 and 8 Arc plans demonstrating that the shape of the isodose covering the PTV is largely dependent on the immediately adjacent critical structures (yellow and blue) that need to be spared in one patient.

<p>As a result, slightly increased volume of the normal lung tissue is included in the high dose volume lateral to the PTV (blue shade) away from the central structures. Also shown here is that when comparing to the 2 Arc plan, the high dose region included by the 77 Gy isodose in the 8 Arc plan is greatly diminished, demonstrating increased homogeneity.</p