Immobilization and Radiotherapy Planning Protocol for Lung Cancer

The details of the treatment procedure were previously described in the phase II study [12 (link)]. All patients were immobilized in the supine position using a body immobilization shell system (Pelvicast; Orfit Industries n.v., Wijnegem, Belgium). Images of the radiotherapy planning were taken using a 16 multislice computed tomography (CT) (Aquilion LB, Toshiba Medical Systems, Tokyo, Japan). The prescribed dose was set at 75 Gy in 30 fractions covering 95% of the planning target volume. The IMRT plan was created using a treatment planning system (Xio ver. 4.6 system, Elekta AB, Stockholm, Sweden). Usually, five non-coplanar beams, three coplanar beams from the caudal direction, and two non-coplanar beams from the cranial direction, were arranged to reduce the OARs, such as the lung, spinal cord and the oesophagus. Chemotherapy was not performed during radiotherapy.