Radiation Oncology (May 2012)

Functional dosimetric metrics for predicting radiation-induced lung injury in non-small cell lung cancer patients treated with chemoradiotherapy

  • Wang Dongqing,
  • Sun Jinbo,
  • Zhu Jingyu,
  • Li Xiaohong,
  • Zhen Yanbo,
  • Sui Songtao

DOI
https://doi.org/10.1186/1748-717X-7-69
Journal volume & issue
Vol. 7, no. 1
p. 69

Abstract

Read online

Abstract Background Radiation-induced lung injury (RILI) is an important dose-limiting toxicity during thoracic radiotherapy. The purpose of this study is to investigate single photon emission computed tomography (SPECT) perfusion-weighted functional dose-volume histogram (FDVH) for predicting RILI in non-small cell lung cancer (NSCLC) patients treated with definitive chemoradiotherapy. Methods Fifty-seven locally advanced NSCLC patients receiving chemoradiotherapy were enrolled prospectively. Patients had treatment scans and dose calculations to provide a standard dose-volume histogram (DVH). Fusion of SPECT and computed tomography scans provided perfusion-weighted FDVH and associated functional dosimetric parameters (relative volumes of functional lung receiving more than a threshold dose of 5 – 60 Gy at increments of 5 Gy [FV5 – FV60]). The predictive abilities of FDVH and DVH were calculated and compared based on the area under receiver operating characteristic (ROC) curve (AUC). Results The accumulative incidence of ≥ 2 grade RILI was 19.3% with a median follow-up of 12 months. Univariate analysis showed that the functional (FV5 – FV60) and standard (V5 – V40) parameters were associated with RILI (all value of p Conclusions Functional metrics are identified as reliable predictors for RILI, however, this observation still needs to be further verified using a larger sample size.

Keywords