Modeling radiation pneumonitis risk with clinical, dosimetric, and spatial parameters

Journal Article · Mon May 01 04:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.1· OSTI ID:20793464

Hope, Andrew J ^[1]; Lindsay, Patricia E ^[1]; El Naqa, Issam ^[1]; Alaly, James R ^[1]; Vicic, Milos ^[1]; Bradley, Jeffrey D ^[1]; Deasy, Joseph O ^[1]

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1. Department of Radiation Oncology, Washington University School of Medicine, Siteman Cancer Center, St. Louis, Missouri (United States)

Purpose: To determine the clinical, dosimetric, and spatial parameters that correlate with radiation pneumonitis. Methods and Materials: Patients treated with high-dose radiation for non-small-cell lung cancer with three-dimensional treatment planning were reviewed for clinical information and radiation pneumonitis (Rp) events. Three-dimensional treatment plans for 219 eligible patients were recovered. Treatment plan information, including parameters defining tumor position and dose-volume parameters, was extracted from non-heterogeneity-corrected dose distributions. Correlation to RP events was assessed by Spearman's rank correlation coefficient (R). Mathematical models were generated that correlate with RP. Results: Of 219 patients, 52 required treatment for RP (median interval, 142 days). Tumor location was the most highly correlated parameter on univariate analysis (R = 0.24). Multiple dose-volume parameters were correlated with RP. Models most frequently selected by bootstrap resampling included tumor position, maximum dose, and D{sub 35} (minimum dose to the 35% volume receiving the highest doses) (R 0.28). The most frequently selected two- or three-parameter models outperformed commonly used metrics, including V{sub 2} (fractional volume of normal lung receiving >20 Gy) and mean lung dose (R = 0.18). Conclusions: Inferior tumor position was highly correlated with pneumonitis events within our population. Models that account for inferior tumor position and dosimetric information, including both high- and low-dose regions (D{sub 35}, International Commission on Radiation Units and Measurements maximum dose), risk-stratify patients more accurately than any single dosimetric or clinical parameter.

• OSTI ID: 20793464
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
HEALTH HAZARDS
INFORMATION
LUNGS
METRICS
PATIENTS
PLANNING
PNEUMONITIS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIOTHERAPY
SIMULATION