PMID- 29609805
OWN - NLM
STAT- MEDLINE
DCOM- 20181022
LR  - 20181022
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 127
IP  - 2
DP  - 2018 May
TI  - Three-dimensional cluster formation and structure in heterogeneous dose 
      distribution of intensity modulated radiation therapy.
PG  - 197-205
LID - S0167-8140(18)30143-9 [pii]
LID - 10.1016/j.radonc.2018.03.011 [doi]
AB  - PURPOSE: To investigate three-dimensional cluster structure and its correlation 
      to clinical endpoint in heterogeneous dose distributions from intensity modulated 
      radiation therapy. METHODS: Twenty-five clinical plans from twenty-one head and 
      neck (HN) patients were used for a phenomenological study of the cluster 
      structure formed from the dose distributions of organs at risks (OARs) close to 
      the planning target volumes (PTVs). Initially, OAR clusters were searched to 
      examine the pattern consistence among ten HN patients and five clinically similar 
      plans from another HN patient. Second, clusters of the esophagus from another ten 
      HN patients were scrutinized to correlate their sizes to radiobiological 
      parameters. Finally, an extensive Monte Carlo (MC) procedure was implemented to 
      gain deeper insights into the behavioral properties of the cluster formation. 
      RESULTS: Clinical studies showed that OAR clusters had drastic differences 
      despite similar PTV coverage among different patients, and the radiobiological 
      parameters failed to positively correlate with the cluster sizes. MC study 
      demonstrated the inverse relationship between the cluster size and the cluster 
      connectivity, and the nonlinear changes in cluster size with dose thresholds. In 
      addition, the clusters were insensitive to the shape of OARs. CONCLUSION: The 
      results demonstrated that the cluster size could serve as an insightful index of 
      normal tissue damage. The clinical outcome of the same dose-volume might be 
      potentially different.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Chao, Ming
AU  - Chao M
AD  - Department of Radiation Oncology, Mount Sinai Medical Center, New York, USA. 
      Electronic address: ming.chao@mountsinai.org.
FAU - Wei, Jie
AU  - Wei J
AD  - Department of Computer Science, City College of New York, USA.
FAU - Narayanasamy, Ganesh
AU  - Narayanasamy G
AD  - Department of Radiation Oncology, University of Arkansas for Medical Sciences, 
      Little Rock, USA.
FAU - Yuan, Yading
AU  - Yuan Y
AD  - Department of Radiation Oncology, Mount Sinai Medical Center, New York, USA.
FAU - Lo, Yeh-Chi
AU  - Lo YC
AD  - Department of Radiation Oncology, Mount Sinai Medical Center, New York, USA.
FAU - Penagaricano, Jose A
AU  - Penagaricano JA
AD  - Department of Radiation Oncology, University of Arkansas for Medical Sciences, 
      Little Rock, USA.
LA  - eng
PT  - Journal Article
DEP - 20180330
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Esophagus/radiation effects
MH  - Head and Neck Neoplasms/*radiotherapy
MH  - Humans
MH  - Male
MH  - Monte Carlo Method
MH  - Organs at Risk
MH  - Parotid Gland/radiation effects
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Intensity-Modulated/methods
OTO - NOTNLM
OT  - Cluster model
OT  - Dose-volume histogram
OT  - Heterogeneous dose distribution
OT  - Intensity modulated radiation therapy
OT  - Normal tissue complication probability
EDAT- 2018/04/04 06:00
MHDA- 2018/10/23 06:00
CRDT- 2018/04/04 06:00
PHST- 2017/08/31 00:00 [received]
PHST- 2018/03/12 00:00 [revised]
PHST- 2018/03/13 00:00 [accepted]
PHST- 2018/04/04 06:00 [pubmed]
PHST- 2018/10/23 06:00 [medline]
PHST- 2018/04/04 06:00 [entrez]
AID - S0167-8140(18)30143-9 [pii]
AID - 10.1016/j.radonc.2018.03.011 [doi]
PST - ppublish
SO  - Radiother Oncol. 2018 May;127(2):197-205. doi: 10.1016/j.radonc.2018.03.011. Epub 
      2018 Mar 30.