Inclusion of Incidental Radiation Dose to the Cardiac Atria and Ventricles Does Not Improve the Prediction of Radiation Pneumonitis in Advanced-Stage Non-Small Cell Lung Cancer Patients Treated With Intensity Modulated Radiation Therapy

Robin Wijsman*, Frank J. W. M. Dankers, Esther G. C. Troost, Aswin L. Hoffmann, Erik H. F. M. van der Heijden, Lioe-Fee de Geus-Oei, Johan Bussink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)

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 doseevolume 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= 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. (C) 2017 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)434-441
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume99
Issue number2
DOIs
Publication statusPublished - 1 Oct 2017

Keywords

  • HEART IRRADIATION
  • RISK-FACTOR
  • RADIOTHERAPY
  • VOLUME
  • TOXICITY
  • METAANALYSIS
  • EXPOSURE
  • IMPACT
  • ATLAS

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