Gilles Defraene1, Wouter van Elmpt2, Wouter Crijns3, Pieter Slagmolen4, Dirk De Ruysscher5. 1. KU Leuven - University of Leuven, Department of Oncology, Experimental Radiation Oncology, B-3000 Leuven, Belgium. Electronic address: gilles.defraene@uzleuven.be. 2. Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands. 3. KU Leuven - University of Leuven, Department of Oncology, Experimental Radiation Oncology, B-3000 Leuven, Belgium; University Hospitals Leuven, Department of Radiation Oncology, B-3000 Leuven, Belgium; KU Leuven Medical Imaging Research Center, B-3000 Leuven, Belgium. 4. KU Leuven Medical Imaging Research Center, B-3000 Leuven, Belgium; KU Leuven, ESAT/PSI - UZ Leuven, MIRC - iMinds, Medical IT Dept, Belgium. 5. KU Leuven - University of Leuven, Department of Oncology, Experimental Radiation Oncology, B-3000 Leuven, Belgium; University Hospitals Leuven, Department of Radiation Oncology, B-3000 Leuven, Belgium.
Abstract
BACKGROUND AND PURPOSE: There is a huge difference in radiosensitivity of lungs between patients. The present study aims to identify and quantify patient-specific radiosensitivity based on a single pre-treatment CT scan. MATERIALS AND METHODS: 130 lung cancer patients were studied: 60 stereotactic ablative radiotherapy (SABR) treatments and 70 conventional treatments (20 and 30 patients from external datasets, respectively). A 3month-follow-up scan (CT3M) was non-rigidly registered to the planning CT scan (CT0). Changes in Hounsfield Units (ΔHU=HU3M-HU0) inside lung subvolumes were analyzed per dose bin of 5Gy. ΔHU was modeled as a function of local dose using linear and sigmoidal fits. Sigmoidal fit parameters ΔHUmax (saturation level) and D50 (dose corresponding to 50% of ΔHUmax) were collected for all patients. RESULTS: Sigmoidal fits outperformed linear fits in the SABR groups for the majority of patients. Sigmoidal dose-responses were also observed in both conventional groups but to a lesser extent. Distributions of D50 and ΔHUmax showed a large variation between patients in all datasets. Higher baseline lung density (p<0.001) was prognostic for higher ΔHUmax in one SABR group. No prognostic factors were found for D50. CONCLUSIONS: Baseline CT characteristics are prognostic for radiation-induced lung damage susceptibility.
BACKGROUND AND PURPOSE: There is a huge difference in radiosensitivity of lungs between patients. The present study aims to identify and quantify patient-specific radiosensitivity based on a single pre-treatment CT scan. MATERIALS AND METHODS: 130 lung cancerpatients were studied: 60 stereotactic ablative radiotherapy (SABR) treatments and 70 conventional treatments (20 and 30 patients from external datasets, respectively). A 3month-follow-up scan (CT3M) was non-rigidly registered to the planning CT scan (CT0). Changes in Hounsfield Units (ΔHU=HU3M-HU0) inside lung subvolumes were analyzed per dose bin of 5Gy. ΔHU was modeled as a function of local dose using linear and sigmoidal fits. Sigmoidal fit parameters ΔHUmax (saturation level) and D50 (dose corresponding to 50% of ΔHUmax) were collected for all patients. RESULTS:Sigmoidal fits outperformed linear fits in the SABR groups for the majority of patients. Sigmoidal dose-responses were also observed in both conventional groups but to a lesser extent. Distributions of D50 and ΔHUmax showed a large variation between patients in all datasets. Higher baseline lung density (p<0.001) was prognostic for higher ΔHUmax in one SABR group. No prognostic factors were found for D50. CONCLUSIONS: Baseline CT characteristics are prognostic for radiation-induced lung damage susceptibility.
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