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Title: Correlation of dosimetric parameters obtained with the analytical anisotropic algorithm and toxicity of chest chemoradiation in lung carcinoma

Journal Article · · Medical Dosimetry
; ; ;  [1];  [2];  [3];  [4]; ;  [1];  [4];  [5];  [1];
  1. Departement de Radiotherapie, Institut de Cancerologie de la Loire, St-Priest en Jarez (France)
  2. Service d'Oncologie Radiotherapie, Hopital d'Instruction des Armees du Val-de-Grace, Paris (France)
  3. Departement de Sante Publique, Unite de Statistique, Institut de Cancerologie de la Loire, St-Priest en Jarez (France)
  4. Departement d'Oncologie Medicale, Institut de Cancerologie de la Loire, St-Priest en Jarez (France)
  5. Service de Chirurgie Thoracique, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne (France)

The purpose of this study was to analyze and revisit toxicity related to chest chemoradiotherapy and to correlate these side effects with dosimetric parameters obtained using analytical anisotropic algorithm (AAA) in locally unresectable advanced lung cancer. We retrospectively analyzed data from 47 lung cancer patients between 2005 and 2008. All received conformal 3D radiotherapy using high-energy linear accelerator plus concomitant chemotherapy. All treatment planning data were transferred into Eclipse 8.05 (Varian Medical Systems, Palo Alto, CA) and dosimetric calculations were performed using AAA. Thirty-three patients (70.2%) developed acute pneumopathy after radiotherapy (grades 1 and 2). One patient (2.1%) presented with grade 3 pneumopathy. Thirty-one (66%) presented with grades 1-2 lung fibrosis, and 1 patient presented with grade 3 lung fibrosis. Thirty-four patients (72.3%) developed grade 1-2 acute oesophagic toxicity. Four patients (8.5%) presented with grades 3 and 4 dysphagia, necessitating prolonged parenteral nutrition. Median prescribed dose was 64 Gy (range 50-74) with conventional fractionation (2 Gy per fraction). Dose-volume constraints were respected with a median V20 of 23.5% (maximum 34%) and a median V30 of 17% (maximum 25%). The median dose delivered to healthy contralateral lung was 13.1 Gy (maximum 18.1 Gy). At univariate analysis, larger planning target volume and V20 were significantly associated with the probability of grade {>=}2 radiation-induced pneumopathy (p = 0.022 and p = 0.017, respectively). No relation between oesophagic toxicity and clinical/dosimetric parameters could be established. Using AAA, the present results confirm the predictive value of the V20 for lung toxicity as already demonstrated with the conventional pencil beam convolution approach.

OSTI ID:
22130396
Journal Information:
Medical Dosimetry, Vol. 37, Issue 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0958-3947
Country of Publication:
United States
Language:
English