Critical dose and toxicity index of organs at risk in radiotherapy: analyzing the calculated effects of modified dose fractionation in non-small cell lung cancer
Critical dose and toxicity index of organs at risk in radiotherapy: analyzing the calculated effects of modified dose fractionation in non-small cell lung cancer(661 views) Pedicini P, Strigari L, Benassi M, Caivano R, Fiorentino A, Nappi A, Salvatore M, Storto G
Med Dosim (ISSN: 0958-3947, 1873-4022), 2014 Mar; 39(1): 23-30.
Service of Medical Physics, I.R.C.C.S. Regional Cancer Hospital C.R.O.B, Rionero in Vulture, Italy. Electronic address: ppiern@libero.it.
Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy
U.O. of Radiotherapy, I.R.C.C.S. Regional Cancer Hospital C.R.O.B., Rionero in Vulture, Italy
U.O. of Nuclear Medicine, I.R.C.C.S. Regional Cancer Hospital C.R.O.B., Rionero in Vulture, Italy
U. O. of Radiotherapy, I. R. C. C. S. Regional Cancer Hospital C. R. O. B., Rionero in Vulture, Italy
U. O. of Nuclear Medicine, I. R. C. C. S. Regional Cancer Hospital C. R. O. B., Rionero in Vulture, Italy
References: Baumann, M., Krause, M., Dikomey, E., EGFR targeted anticancer drugs in radiotherapy: preclinical evaluation of mechanisms (2007) Radiother. Oncol., 83, pp. 238-24
Bentzen, S.M., Overgaard, J., Clinical normal tissue radiobiology (1996) Current Radiation Oncology, pp. 37-67. , Arnold, London
Vermeulen, C., Verwijs Janssen, M., Begg, A.C., Cell cycle phase dependent role of DNA repair and survival after ionizing radiation (2008) Radiother. Oncol., 86, pp. 391-398
Thames, H.D., Bentzen, S.M., Turesson, I., Time dose factors in radiotherapy: a review of the human data (1990) Radiother. Oncol., 19, pp. 219-235
Jenkins, P., Anderson, S., Wronski, S., A phase II trial of induction chemotherapy followed by continuous hyperfractionated accelerated radiotherapy in locally advanced non-small cell lung cancer (2009) Radiother. Oncol., 93, pp. 396-401
Zhu, Z.F., Fan, M., Wu, K.L., A phase II trial of accelerated hypofractionated tree dimensional conformal radiation therapy in locally advanced non-small cell lung cancer (2011) Radiother. Oncol., 98, pp. 304-308
Baumann, M., Herrmann, T., Koch, R., Final results of the randomized III CHARTWEL trial (ARO 97 1) comparing hyperfractionated accelerated versus conventional fractionated radiotherapy in non-small cell lung cancer (NSCLC) (2011) Radiother. Oncol., 100, pp. 76-85
Kutcher, G.J., Burman, C., Calculation of complication-probability factors for non uniform normal tissue irradiation: the effective volume method (1989) Int. J. Radiat. Oncol. Biol. Phys., 16, pp. 1623-1630
Niemierko, A., Reporting and analyzing dose distribution: a concept of equivalent uniform dose (1997) Med. Phys., 24, pp. 103-110
Dumas, J.L., Lorchel, F., Perrot, Y., Equivalent uniform dose concept evaluated by theoretical dose volume histograms for thoracic irradiation (2007) Phys. Med., 23, pp. 16-24
Giraud, P., Antoine, M., Larrouy, A., Evaluation of microscopic tumour extension in non-small cell lung cancer for three dimensional conformal radiotherapy planning (2000) Int. J. Radiat. Oncol. Biol. Phys., 48, pp. 1015-1024
Burman, C., Kutcher, G.J., Emami, B., Fitting of normal tissue tolerance data to an analytic function (1991) Int. J. Radiat. Oncol. Biol. Phys., 21, pp. 123-135
Lee, S.P., Leu, M.Y., Smathers, J.B., Biologically effective dose distribution based on the linear quadratic model and its clinical relevance (1995) Int. J. Radiat. Oncol. Biol. Phys., 33, pp. 375-389
Fowler, J.F., Chappell, R., Non-small cell lung tumors repopulate rapidly during radiation therapy (2000) Int. J. Radiat. Oncol. Biol. Phys., 46, pp. 516-517
Rosenzweig, K.E., Sim, S., Mychalczak, B., Elective nodal irradiation in the treatment of non-small cell lung cancer with three dimensional conformal radiation therapy (3D-CRT) (2001) Int. J. Radiat. Oncol. Biol. Phys., 49, pp. 1229-1234
Lyman, J.T., Wolbarst, B., Optimization of radiation therapy, III: a method of assessing complication probabilities from dose-volume histograms (1987) Int. J. Radiat. Oncol. Biol. Phys., 13, pp. 103-109
Kwa, S.L., Theuws, J.C., Wagenaar, A., Evaluation of two dose volume histogram reduction models for the prediction of radiation pneumonitis (1998) Radiother. Oncol., 48, pp. 61-69
Rodriguez, G., Lock, M., D'Souza, D., Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer: a systematic review (2004) Radiother. Oncol., 71, pp. 127-138
Pedicini, P., Caivano, R., Jereczek Fossa, B.A., Modelling the correlation between EGFr expression and tumour cell radiosensitivity, and combined treatments of radiation and monoclonal antibody EGFr inhibitors (2012) Theor. Biol. Med. Model., 9, p. 23
Pedicini, P., Nappi, A., Strigari, L., Correlation between EGFr expression and accelerated proliferation during radiotherapy of head and neck squamous cell carcinoma (2012) Radiat. Oncol., 24, p. 143
Pedicini, P., Fiorentino, A., Improta, G., Estimate of the accelerated proliferation by protein tyrosine phosphatase (PTEN) over expression in postoperative radiotherapy of head and neck squamous cell carcinoma (2013) Clin. Transl. Oncol., , http://dx.doi.org/10.1007/s12094-013-1024-2
Pedicini, P., Strigari, L., Benassi, M., Estimation of a self-consistent set of radiobiological parameters from hypofractionated versus standard radiation therapy of prostate cancer (2013) Int. J. Radiat. Oncol. Biol. Phys., 85, pp. e231-e237
Critical dose and toxicity index of organs at risk in radiotherapy: analyzing the calculated effects of modified dose fractionation in non-small cell lung cancer
To increase the efficacy of radiotherapy for non-small cell lung cancer (NSCLC), many schemes of dose fractionation were assessed by a new "toxicity index" (I), which allows one to choose the fractionation schedules that produce less toxic treatments. Thirty-two patients affected by non resectable NSCLC were treated by standard 3-dimensional conformal radiotherapy (3DCRT) with a strategy of limited treated volume. Computed tomography datasets were employed to re plan by simultaneous integrated boost intensity-modulated radiotherapy (IMRT). The dose distributions from plans were used to test various schemes of dose fractionation, in 3DCRT as well as in IMRT, by transforming the dose-volume histogram (DVH) into a biological equivalent DVH (BDVH) and by varying the overall treatment time. The BDVHs were obtained through the toxicity index, which was defined for each of the organs at risk (OAR) by a linear quadratic model keeping an equivalent radiobiological effect on the target volume. The less toxic fractionation consisted in a severe/moderate hyper fractionation for the volume including the primary tumor and lymph nodes, followed by a hypofractionation for the reduced volume of the primary tumor. The 3DCRT and IMRT resulted, respectively, in 4.7% and 4.3% of dose sparing for the spinal cord, without significant changes for the combined-lungs toxicity (p < 0.001). Schedules with reduced overall treatment time (accelerated fractionations) led to a 12.5% dose sparing for the spinal cord (7.5% in IMRT), 8.3% dose sparing for V20 in the combined lungs (5.5% in IMRT), and also significant dose sparing for all the other OARs (p < 0.001). The toxicity index allows to choose fractionation schedules with reduced toxicity for all the OARs and equivalent radiobiological effect for the tumor in 3DCRT, as well as in IMRT, treatments of NSCLC. Copyright 2014 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
Critical dose and toxicity index of organs at risk in radiotherapy: analyzing the calculated effects of modified dose fractionation in non-small cell lung cancer
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Critical dose and toxicity index of organs at risk in radiotherapy: analyzing the calculated effects of modified dose fractionation in non-small cell lung cancer