Original ArticleClinical and dosimetric predictors of radiation pneumonitis in early-stage lung cancer treated with Stereotactic Ablative radiotherapy (SABR) – An analysis of UK’s largest cohort of lung SABR patients
Section snippets
Materials and methods
Patients treated with lung SABR, between May 2009 and August 2018; in a single United Kingdom (UK) radiotherapy center was included. Patient baseline characteristics, treatment details, and toxicity were retrieved from the electronic medical record. Dosimetric data was extracted from Xio and Monaco treatment planning systems. For the planning target volume (PTV), plan conformity was assessed using three indices, i.e., R100-volume receiving 100% of prescribed dose /volume (PTV), R50-volume
Results
Twelve hundred sixty-six patients with stage I/II lung cancer was treated with SABR between May 2009 and August 2018. Baseline clinical characteristics are summarised in Table 1a, Table 1b. The median age was 75 years and 666 (52.6%) of patients were female. Smoking history was available for 76.2% of patients; 26.5% were current smokers, 46.1% ex-smokers, and 3.6% never smokers. Smoking pack-years history was documented for 29.3% of patients. Sixty percent of patients had a poor performance
Discussion
In this retrospective review, we have analyzed the UK's largest cohort of early-stage medically inoperable lung cancer patients treated with SABR, to explore the clinical and dosimetric predictors of symptomatic RP. The reported incidence of symptomatic RP (≥2 Grade) in the published literature ranges from 9 to 28% [10], [11], [12], [13]. A pooled analysis by Nan Bi el containing 2767 patients from 31 eligible studies on SABR found the most frequent grade ≥ 3 toxicity to be RP with an incidence
Source(s) of support
Nil.
Presentation at a meeting
Nil.
Conflicting interest
Nil.
Acknowledgement
The authors acknowledges the support and hard work of all the colleagues of St James’s University Hospital, Leeds.
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2023, International Journal of Radiation Oncology Biology PhysicsCitation Excerpt :In a different context, the occurrence of RP is strongly related with RT dose; therefore, a number of studies have used dose-volume histogram (DVH) metrics, such as mean lung dose (MLD)22 and volume of the lung receiving 20 Gy (V20),23 to predict RP. DVH parameters are not able to fully describe the immense spatial heterogeneity of dose distribution, which may be realized through intensity modulated radiation delivery (ie, intensity modulated RT and/or volumetric modulated arc therapy).23,24 Dosiomics, conceived using radiomic tools to characterize spatial heterogeneity of RT doses (as opposed to image voxel intensities), provides a greater depth of information in contrast with traditional DVH measures.25,26
Pseudo-siamese network combined with dosimetric and clinical factors, radiomics features, CT images and 3D dose distribution for the prediction of radiation pneumonitis: A feasibility study
2023, Clinical and Translational Radiation OncologyCitation Excerpt :The advantage of our model is that RP would be predicted before the first delivery. Dosimetric factors were proved considerable for predicting RP in previous study, such as lung V20, mean lung dose, PTV [24]. Since 3D dose distribution as input, this study hasn’t compared these dosimetric parameter which have high correlation with RP.