AIM: The purpose of this work was to prove the validity of the mean lung dose (MLD), widely used in clinical practice to estimate the lung toxicity of a treatment plan, by reevaluating experimental data from mini pigs. MATERIALS AND METHODS: A total of 43 mini pigs were irradiated in one of four dose groups (25, 29, 33, and 37 Gy). Two regimens were applied: homogeneous irradiation of the right lung or partial irradiation of both lungs-including parts with lower dose-but with similar mean lung doses. The animals were treated with five fractions with a linear accelerator applying a CT-based treatment plan. The clinical lung reaction (breathing frequency) and morphological changes in CT scans were examined frequently during the 48 weeks after irradiation. RESULTS: A clear dose-effect relationship was found for both regimens of the trial. However, a straightforward relationship between the MLD and the relative number of responders with respect to different grades of increased breathing frequency for both regimens was not found. A morphologically based parameter NTCPlung was found to be more suitable for this purpose. The dependence of this parameter on the MLD is markedly different for the two regimens. CONCLUSION: In clinical practice, the MLD can be used to predict lung toxicity of a treatment plan, except for dose values that could lead to severe side effects. In the latter mentioned case, limitations to the predictive value of the MLD are possible. Such severe developments of a radiation-induced pneumopathy are better predicted by the NTCPlung formalism. The predictive advantage of this parameter compared to the MLD seems to remain in the evaluation and comparison of widely differing dose distributions, like in the investigated trial.
AIM: The purpose of this work was to prove the validity of the mean lung dose (MLD), widely used in clinical practice to estimate the lung toxicity of a treatment plan, by reevaluating experimental data from mini pigs. MATERIALS AND METHODS: A total of 43 mini pigs were irradiated in one of four dose groups (25, 29, 33, and 37 Gy). Two regimens were applied: homogeneous irradiation of the right lung or partial irradiation of both lungs-including parts with lower dose-but with similar mean lung doses. The animals were treated with five fractions with a linear accelerator applying a CT-based treatment plan. The clinical lung reaction (breathing frequency) and morphological changes in CT scans were examined frequently during the 48 weeks after irradiation. RESULTS: A clear dose-effect relationship was found for both regimens of the trial. However, a straightforward relationship between the MLD and the relative number of responders with respect to different grades of increased breathing frequency for both regimens was not found. A morphologically based parameter NTCPlung was found to be more suitable for this purpose. The dependence of this parameter on the MLD is markedly different for the two regimens. CONCLUSION: In clinical practice, the MLD can be used to predict lung toxicity of a treatment plan, except for dose values that could lead to severe side effects. In the latter mentioned case, limitations to the predictive value of the MLD are possible. Such severe developments of a radiation-induced pneumopathy are better predicted by the NTCPlung formalism. The predictive advantage of this parameter compared to the MLD seems to remain in the evaluation and comparison of widely differing dose distributions, like in the investigated trial.
Authors: David A Palma; Suresh Senan; Cornelis J A Haasbeek; Wilko F A R Verbakel; Andrew Vincent; Frank Lagerwaard Journal: Int J Radiat Oncol Biol Phys Date: 2010-06-26 Impact factor: 7.038
Authors: Ghazaleh Ghobadi; Sonja van der Veen; Beatrijs Bartelds; Rudolf A de Boer; Michael G Dickinson; Johan R de Jong; Hette Faber; Maarten Niemantsverdriet; Sytze Brandenburg; Rolf M F Berger; Johannes A Langendijk; Robert P Coppes; Peter van Luijk Journal: Int J Radiat Oncol Biol Phys Date: 2012-09-11 Impact factor: 7.038
Authors: David A Palma; Suresh Senan; Kayoko Tsujino; Robert B Barriger; Ramesh Rengan; Marta Moreno; Jeffrey D Bradley; Tae Hyun Kim; Sara Ramella; Lawrence B Marks; Luigi De Petris; Larry Stitt; George Rodrigues Journal: Int J Radiat Oncol Biol Phys Date: 2012-06-09 Impact factor: 7.038
Authors: Wouter van Elmpt; Dirk De Ruysscher; Anke van der Salm; Annemarie Lakeman; Judith van der Stoep; Daisy Emans; Eugène Damen; Michel Öllers; Jan-Jakob Sonke; José Belderbos Journal: Radiother Oncol Date: 2012-04-06 Impact factor: 6.280
Authors: Susan L Tucker; Hekun Jin; Xiong Wei; Shulian Wang; Mary K Martel; Ritsuko Komaki; H Helen Liu; Radhe Mohan; Yuhchyau Chen; James D Cox; Zhongxing Liao Journal: Int J Radiat Oncol Biol Phys Date: 2009-10-14 Impact factor: 7.038
Authors: Matthias Guckenberger; Rainer J Klement; Larry L Kestin; Andrew J Hope; Jose Belderbos; Maria Werner-Wasik; Di Yan; Jan-Jakob Sonke; Jean-Pierre Bissonnette; Ying Xiao; Inga S Grills Journal: Int J Radiat Oncol Biol Phys Date: 2012-11-12 Impact factor: 7.038
Authors: Yvette Seppenwoolde; Katrien De Jaeger; Liesbeth J Boersma; José S A Belderbos; Joos V Lebesque Journal: Int J Radiat Oncol Biol Phys Date: 2004-11-01 Impact factor: 7.038
Authors: Vladimir A Semenenko; Robert C Molthen; Chunrong Li; Natalya V Morrow; Rongshan Li; Swarajit N Ghosh; Meetha M Medhora; X Allen Li Journal: Int J Radiat Oncol Biol Phys Date: 2008-04-24 Impact factor: 7.038