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Article: Effect of normal lung definition on lung dosimetry and lung toxicity prediction in radiation therapy treatment planning

TitleEffect of normal lung definition on lung dosimetry and lung toxicity prediction in radiation therapy treatment planning
Authors
Issue Date2013
Citation
International Journal of Radiation Oncology Biology Physics, 2013, v. 86, n. 5, p. 956-963 How to Cite?
AbstractPurpose: This study aimed to compare lung dose-volume histogram (DVH) parameters such as mean lung dose (MLD) and the lung volume receiving ≥20 Gy (V20) of commonly used definitions of normal lung in terms of tumor/target subtraction and to determine to what extent they differ in predicting radiation pneumonitis (RP). Methods and Materials: One hundred lung cancer patients treated with definitive radiation therapy were assessed. The gross tumor volume (GTV) and clinical planning target volume (PTVc) were defined by the treating physician and dosimetrist. For this study, the clinical target volume (CTV) was defined as GTV with 8-mm uniform expansion, and the PTV was defined as CTV with an 8-mm uniform expansion. Lung DVHs were generated with exclusion of targets: (1) GTV (DVHG); (2) CTV (DVHC); (3) PTV (DVHP); and (4) PTVc(DVHPc). The lung DVHs, V20s, and MLDs from each of the 4 methods were compared, as was their significance in predicting radiation pneumonitis of grade 2 or greater (RP2). Results: There are significant differences in dosimetric parameters among the various definition methods (all Ps<.05). The mean and maximum differences in V20 are 4.4% and 12.6% (95% confidence interval 3.6%-5.1%), respectively. The mean and maximum differences in MLD are 3.3 Gy and 7.5 Gy (95% confidence interval, 1.7-4.8 Gy), respectively. MLDs of all methods are highly correlated with each other and significantly correlated with clinical RP2, although V20s are not. For RP2 prediction, on the receiver operating characteristic curve, MLD from DVHG(MLDG) has a greater area under curve of than MLD from DVHC(MLDC) or DVHP(MLDP). Limiting RP2 to 30%, the threshold is 22.4, 20.6, and 18.8 Gy, for MLDG, MLDC, and MLDP, respectively. Conclusions: The differences in MLD and V20 from various lung definitions are significant. MLD from the GTV exclusion method may be more accurate in predicting clinical significant radiation pneumonitis. © 2013 Elsevier Inc.
Persistent Identifierhttp://hdl.handle.net/10722/266963
ISSN
2023 Impact Factor: 6.4
2023 SCImago Journal Rankings: 1.992
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, Weili-
dc.contributor.authorXu, Yaping-
dc.contributor.authorSchipper, Matthew-
dc.contributor.authorMatuszak, Martha M.-
dc.contributor.authorRitter, Timothy-
dc.contributor.authorCao, Yue-
dc.contributor.authorTen Haken, Randall K.-
dc.contributor.authorKong, Feng Ming-
dc.date.accessioned2019-01-31T07:20:06Z-
dc.date.available2019-01-31T07:20:06Z-
dc.date.issued2013-
dc.identifier.citationInternational Journal of Radiation Oncology Biology Physics, 2013, v. 86, n. 5, p. 956-963-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/266963-
dc.description.abstractPurpose: This study aimed to compare lung dose-volume histogram (DVH) parameters such as mean lung dose (MLD) and the lung volume receiving ≥20 Gy (V20) of commonly used definitions of normal lung in terms of tumor/target subtraction and to determine to what extent they differ in predicting radiation pneumonitis (RP). Methods and Materials: One hundred lung cancer patients treated with definitive radiation therapy were assessed. The gross tumor volume (GTV) and clinical planning target volume (PTVc) were defined by the treating physician and dosimetrist. For this study, the clinical target volume (CTV) was defined as GTV with 8-mm uniform expansion, and the PTV was defined as CTV with an 8-mm uniform expansion. Lung DVHs were generated with exclusion of targets: (1) GTV (DVHG); (2) CTV (DVHC); (3) PTV (DVHP); and (4) PTVc(DVHPc). The lung DVHs, V20s, and MLDs from each of the 4 methods were compared, as was their significance in predicting radiation pneumonitis of grade 2 or greater (RP2). Results: There are significant differences in dosimetric parameters among the various definition methods (all Ps<.05). The mean and maximum differences in V20 are 4.4% and 12.6% (95% confidence interval 3.6%-5.1%), respectively. The mean and maximum differences in MLD are 3.3 Gy and 7.5 Gy (95% confidence interval, 1.7-4.8 Gy), respectively. MLDs of all methods are highly correlated with each other and significantly correlated with clinical RP2, although V20s are not. For RP2 prediction, on the receiver operating characteristic curve, MLD from DVHG(MLDG) has a greater area under curve of than MLD from DVHC(MLDC) or DVHP(MLDP). Limiting RP2 to 30%, the threshold is 22.4, 20.6, and 18.8 Gy, for MLDG, MLDC, and MLDP, respectively. Conclusions: The differences in MLD and V20 from various lung definitions are significant. MLD from the GTV exclusion method may be more accurate in predicting clinical significant radiation pneumonitis. © 2013 Elsevier Inc.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Radiation Oncology Biology Physics-
dc.titleEffect of normal lung definition on lung dosimetry and lung toxicity prediction in radiation therapy treatment planning-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2013.05.003-
dc.identifier.pmid23845844-
dc.identifier.scopuseid_2-s2.0-84880029654-
dc.identifier.volume86-
dc.identifier.issue5-
dc.identifier.spage956-
dc.identifier.epage963-
dc.identifier.eissn1879-355X-
dc.identifier.isiWOS:000321743600032-
dc.identifier.issnl0360-3016-

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