PMID- 33163312
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210625
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 10
DP  - 2020 Oct 5
TI  - Dose-Volume Predictors of Radiation Pneumonitis After Lung Stereotactic Body 
      Radiation Therapy (SBRT): Implications for Practice and Trial Design.
PG  - e10808
LID - 10.7759/cureus.10808 [doi]
LID - e10808
AB  - Background and purpose Recently published HyTEC report summarized lung toxicity 
      data and proposed guidelines of mean lung dose (MLD) <8 Gy and normal lung 
      receiving at least 20 Gy, V(20Gy)<10-15% to avoid lung toxicity. Support for 
      preferred use of a particular dosimetric parameter has been limited. We performed 
      a detailed dose-volume analysis of data on radiation pneumonitis (RP) following 
      lung stereotactic body radiation therapy (SBRT) to search for parameters showing 
      the strongest correlation with RP. Materials and methods Two patient cohorts 
      (primary and metastatic lung tumor patients) from previously reported studies 
      were analyzed. Total number of patients was 96, and incidence of grade >/=2 RP was 
      13.5% (13/96). Fitting to the logistic function was performed to investigate 
      correlation between incidence of RP and reported dosimetric and volumetric 
      parameters. Another independent cohort was used to explore correlation between 
      dosimetric parameters. Results Among normal lung parameters (MLD and reported 
      V(x)), only MLD consistently showed significant correlation with incidence of RP. 
      Gross tumor volume (GTV), internal target volume, planning target volume (PTV), 
      and minimum dose covering 95% of GTV or PTV did not show statistical 
      significance. A significant correlation between reported V(x) and MLD was 
      observed in all cohorts. Conclusions In considering tumor- and target-specific 
      (e.g., GTV, PTV) and normal lung-specific (e.g., MLD, V(x)) metrics, MLD was the 
      only parameter that consistently correlated with incidence of RP across both 
      cohorts. Because SBRT planning constraints allow small normal lung volumes to 
      receive high doses, utility of MLD is not obvious. The parallel structure of lung 
      is one possible explanation, but correlation between dosimetric parameters 
      obscures elucidation of the preferred or mechanistically based parameter to guide 
      radiotherapy planning.
CI  - Copyright (c) 2020, Moiseenko et al.
FAU - Moiseenko, Vitali
AU  - Moiseenko V
AD  - Radiation Medicine and Applied Sciences, University of California San Diego 
      Moores Cancer Center, La Jolla, USA.
FAU - Grimm, Jimm
AU  - Grimm J
AD  - Radiation Oncology, Geisinger Health System, Danville, USA.
FAU - Yorke, Ellen
AU  - Yorke E
AD  - Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
FAU - Jackson, Andrew
AU  - Jackson A
AD  - Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
FAU - Yip, Anthony
AU  - Yip A
AD  - Radiation Medicine and Applied Sciences, University of California San Diego 
      Moores Cancer Center, La Jolla, USA.
FAU - Huynh-Le, Minh-Phuong
AU  - Huynh-Le MP
AD  - Radiation Medicine and Applied Sciences, University of California San Diego 
      Moores Cancer Center, La Jolla, USA.
FAU - Mahadevan, Anand
AU  - Mahadevan A
AD  - Radiation Oncology, Geisinger Cancer Institute, Danville, USA.
FAU - Forster, Kenneth
AU  - Forster K
AD  - Radiation Oncology, Geisinger Cancer Institute, Danville, USA.
FAU - Milano, Michael T
AU  - Milano MT
AD  - Radiology Oncology, Wilmot Cancer Institute, University of Rochester, Rochester, 
      USA.
FAU - Hattangadi-Gluth, Jona A
AU  - Hattangadi-Gluth JA
AD  - Radiation Medicine and Applied Sciences, University of California San Diego 
      Moores Cancer Center, La Jolla, USA.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
GR  - R01 CA238783/CA/NCI NIH HHS/United States
GR  - TL1 TR001443/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20201005
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7641492
OTO - NOTNLM
OT  - dose-volume-response
OT  - radiation pneumonitis
OT  - stereotactic body radiation therapy
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/11/10 06:00
MHDA- 2020/11/10 06:01
PMCR- 2020/10/05
CRDT- 2020/11/09 05:32
PHST- 2020/11/09 05:32 [entrez]
PHST- 2020/11/10 06:00 [pubmed]
PHST- 2020/11/10 06:01 [medline]
PHST- 2020/10/05 00:00 [pmc-release]
AID - 10.7759/cureus.10808 [doi]
PST - epublish
SO  - Cureus. 2020 Oct 5;12(10):e10808. doi: 10.7759/cureus.10808.