Robin Wijsman1, Frank J W M Dankers2, Esther G C Troost3, Aswin L Hoffmann4, Erik H F M van der Heijden5, Lioe-Fee de Geus-Oei6, Johan Bussink7. 1. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: robin.wijsman@radboudumc.nl. 2. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiation Oncology (MAASTRO clinic), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany; Department of Radiation Oncology, University Hospital Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany; OncoRay, National Center for Radiation Research in Oncology, Dresden, Germany; German Cancer Consortium, Partner Site Dresden, Dresden, Germany; National Center for Tumour Diseases, Partner Site Dresden, Dresden, Germany. 4. Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany; Department of Radiation Oncology, University Hospital Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany. 5. Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands. 6. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Biomedical Photonic Imaging Group, MIRA Institute, University of Twente, Enschede, The Netherlands; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. 7. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
PURPOSE: To evaluate whether inclusion of incidental radiation dose to the cardiac atria and ventricles improves the prediction of grade ≥3 radiation pneumonitis (RP) in advanced-stage non-small cell lung cancer (AS-NSCLC) patients treated with intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT). METHODS AND MATERIALS: Using a bootstrap modeling approach, clinical parameters and dose-volume histogram (DVH) parameters of lungs and heart (assessing atria and ventricles separately and combined) were evaluated for RP prediction in 188 AS-NSCLC patients. RESULTS: After a median follow-up of 18.4 months, 26 patients (13.8%) developed RP. Only the median mean lung dose (MLD) differed between groups (15.3 Gy vs 13.7 Gy for the RP and non-RP group, respectively; P=.004). The MLD showed the highest Spearman correlation coefficient (Rs) for RP (Rs = 0.21; P<.01). Most Rs of the lung DVH parameters exceeded those of the heart DVH parameters. After predictive modeling using a bootstrap procedure, the MLD was always included in the predictive model for grade ≥3 RP, whereas the heart DVH parameters were seldom included in the model. CONCLUSION: Incidental dose to the cardiac atria and ventricles did not improve RP risk prediction in our cohort of 188 AS-NSCLC patients treated with IMRT or VMAT.
PURPOSE: To evaluate whether inclusion of incidental radiation dose to the cardiac atria and ventricles improves the prediction of grade ≥3 radiation pneumonitis (RP) in advanced-stage non-small cell lung cancer (AS-NSCLC)patients treated with intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT). METHODS AND MATERIALS: Using a bootstrap modeling approach, clinical parameters and dose-volume histogram (DVH) parameters of lungs and heart (assessing atria and ventricles separately and combined) were evaluated for RP prediction in 188 AS-NSCLCpatients. RESULTS: After a median follow-up of 18.4 months, 26 patients (13.8%) developed RP. Only the median mean lung dose (MLD) differed between groups (15.3 Gy vs 13.7 Gy for the RP and non-RP group, respectively; P=.004). The MLD showed the highest Spearman correlation coefficient (Rs) for RP (Rs = 0.21; P<.01). Most Rs of the lung DVH parameters exceeded those of the heart DVH parameters. After predictive modeling using a bootstrap procedure, the MLD was always included in the predictive model for grade ≥3 RP, whereas the heart DVH parameters were seldom included in the model. CONCLUSION: Incidental dose to the cardiac atria and ventricles did not improve RP risk prediction in our cohort of 188 AS-NSCLCpatients treated with IMRT or VMAT.
Authors: Wei Song; Hong Lu; Jie Liu; Di Zhao; Jun Ma; Biyun Zhang; Dahai Yu; Xinchen Sun; Jinkai Li Journal: J Appl Clin Med Phys Date: 2019-08-28 Impact factor: 2.102
Authors: Timo M Deist; Frank J W M Dankers; Gilmer Valdes; Robin Wijsman; I-Chow Hsu; Cary Oberije; Tim Lustberg; Johan van Soest; Frank Hoebers; Arthur Jochems; Issam El Naqa; Leonard Wee; Olivier Morin; David R Raleigh; Wouter Bots; Johannes H Kaanders; José Belderbos; Margriet Kwint; Timothy Solberg; René Monshouwer; Johan Bussink; Andre Dekker; Philippe Lambin Journal: Med Phys Date: 2018-06-13 Impact factor: 4.071