PMID- 17264370 OWN - NLM STAT- MEDLINE DCOM- 20070417 LR - 20191210 IS - 0031-9155 (Print) IS - 0031-9155 (Linking) VI - 52 IP - 4 DP - 2007 Feb 21 TI - NTCP modelling and pulmonary function tests evaluation for the prediction of radiation induced pneumonitis in non-small-cell lung cancer radiotherapy. PG - 1055-73 AB - This work aims to evaluate the predictive strength of the relative seriality, parallel and Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) models regarding the incidence of radiation pneumonitis (RP), in a group of patients following lung cancer radiotherapy and also to examine their correlation with pulmonary function tests (PFTs). The study was based on 47 patients who received radiation therapy for stage III non-small-cell lung cancer. For each patient, lung dose volume histograms (DVHs) and the clinical treatment outcome were available. Clinical symptoms, radiological findings and pulmonary function tests incorporated in a post-treatment follow-up period of 18 months were used to assess the manifestation of radiation induced complications. Thirteen of the 47 patients were scored as having radiation induced pneumonitis, with RTOG criteria grade 3 and 28 of the 47 with RTOG criteria grade 2. Using this material, different methods of estimating the likelihood of radiation effects were evaluated, by analysing patient data based on their full dose distributions and associating the calculated complication rates with the clinical follow-up records. Lungs were evaluated as a paired organ as well as individual lungs. Of the NTCP models examined in the overall group considering the dose distribution in the ipsilateral lung, all models were able to predict radiation induced pneumonitis only in the case of grade 2 radiation pneumonitis score, with the LKB model giving the best results (chi2-test: probability of agreement between the observed and predicted results Pchi(chi2)=0.524 using the 0.05 significance level). The NTCP modelling considering lungs as a paired organ did not give statistically acceptable results. In the case of lung cancer radiotherapy, the application of different published radiobiological parameters alters the NTCP results, but not excessively as in the case of breast cancer radiotherapy. In this relatively small group of lung cancer patients, no positive statistical correlation could be established between the incidence of radiation pneumonitis as estimated by NTCP models and the pulmonary function test evaluation. However, the use of PFTs as markers or predictors for the incidence or severity of radiation induced pneumonitis must be investigated further. FAU - Tsougos, Ioannis AU - Tsougos I AD - Department of Medical Physics, Medical School, University of Thessaly, and University Hospital of Larissa, Greece. jtsoug@med.uth.gr FAU - Nilsson, Per AU - Nilsson P FAU - Theodorou, Kiki AU - Theodorou K FAU - Kjellen, Elisabeth AU - Kjellen E FAU - Ewers, Sven-Borje AU - Ewers SB FAU - Jarlman, Olof AU - Jarlman O FAU - Lind, Bengt K AU - Lind BK FAU - Kappas, Constantin AU - Kappas C FAU - Mavroidis, Panayiotis AU - Mavroidis P LA - eng PT - Evaluation Study PT - Journal Article DEP - 20070125 PL - England TA - Phys Med Biol JT - Physics in medicine and biology JID - 0401220 SB - IM MH - Carcinoma, Non-Small-Cell Lung/complications/*radiotherapy MH - Follow-Up Studies MH - Humans MH - Models, Biological MH - Radiation Pneumonitis/*etiology MH - Radiometry/*methods MH - Radiotherapy/*adverse effects MH - Radiotherapy Dosage MH - Risk Assessment MH - Severity of Illness Index EDAT- 2007/02/01 09:00 MHDA- 2007/04/18 09:00 CRDT- 2007/02/01 09:00 PHST- 2007/02/01 09:00 [pubmed] PHST- 2007/04/18 09:00 [medline] PHST- 2007/02/01 09:00 [entrez] AID - S0031-9155(07)25879-8 [pii] AID - 10.1088/0031-9155/52/4/013 [doi] PST - ppublish SO - Phys Med Biol. 2007 Feb 21;52(4):1055-73. doi: 10.1088/0031-9155/52/4/013. Epub 2007 Jan 25.