Department of Radiation Oncology (Feng X,Ge H,Cheng ZY,Ye K,Yang CL),Department of Nuclear Medicine (Yang H),Henan Cancer Hospital,The Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou 450008,China;Department of Radiation Oncology (Yu JM),Shandong Cancer Hospital,Ji’nan 250117,China;Department of Oncology,Nanyang Central Hospital,Affiliated Nanyang Hospital of Zhengzhou University,Nanyang 473000,China
AbstractObjective To explore the relationship between functional dosimetric parameters of radiotherapy plans and radiation-induced lung injury using single-photon emission computed tomography (SPECT) perfusion lung scintigraphy, and to investigate the advantages of SPECT in optimizing radiotherapy plans. Methods From 2014 to 2015, 23 patients with non-small cell lung cancer (NSCLC) who received SPECT perfusion lung scintigraphy before radiotherapy were enrolled as subjects. The functional dose-volume histogram (fDVH) was generated and the relationship between fVx (the volume proportion of the functional lung tissue exposed to ≥x Gy of radiation in the whole functional lung tissue) and radiation-induced pneumonitis (RP) was explored. The radiotherapy plans were optimized based on SPECT and the dosimetric parameters were then compared between the optimized and conventional radiotherapy plans. The SPSS 13 software was used for chi-square test and receiver operating characteristic curve analysis. Comparison of DVH and fDVH between conventional and optimized radiotherapy plans was made by paired t test. Results The fV13 value for both lungs was most correlated with the incidence of grade ≥2 RP. The fV10, fV13, fV20, fV25, and fV40 values were significantly reduced and the conformity index was significantly improved after optimization (P=0.006,0.007,0.010,0.036,0.035,0.040). Conclusions SPECT can be used to optimize radiotherapy plans. The fV13 value may be correlated with the incidence and severity of RP.
Corresponding Authors:
Ge Hong,Email:gehong666@126.com
Cite this article:
. Value of single-photon emission computed tomography perfusion lung scintigraphy in radiotherapy optimization for non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(3): 287-290.
. Value of single-photon emission computed tomography perfusion lung scintigraphy in radiotherapy optimization for non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(3): 287-290.
[1] Soldà F,Lodge M,Ashley S,et al. Stereotactic radiotherapy (SABR) for the treatment of primary non-small cell lung cancer;Systematic review and comparison with a surgical cohort[J].Radiother Oncol,2013,109(1):1-7.DOI:10.1016/j.radonc.2013.09.006. [2] Trotti A,Colevas AD,Setser A,et al. CTCAE v3.0:development of a comprehensive grading system for the adverse effects of cancer treatment[J].Semin Radiat Oncol,2003,13(3):176-181.DOI:10.1016/S1053-4296(03)00031-6. [3] Dang J,Li G,Lu XB,et al. Analysis of related factors associated with radiation pneumonitis in patients with locally advanced non-small-cell lung cancer treated with three-dimensional conformal radiotherapy[J].J Cancer Res Clin Oncol,2010,136(8):1169-1178.DOI:10.1007/s00432-010-0764-4. [4] Seppenwoolde Y,Muller SH,Theuws JCM,et al. Radiation dose-effect relations and local recovery in perfusion for patients with non-small-cell lung cancer[J].Int J Radiat Oncol Biol Phys,2000,47(3):681-690.DOI:10.1016/S0360-3016(00)00454-5. [5] Mehta V.Radiation pneumonitis and pulmonary fibrosis in non-small-cell lung cancer:pulmonary function,prediction,and prevention[J].Int J Radiat Oncol Biol Phys,2005,63(1):5-24.DOI:10.1016/j.ijrobp.2005.03.047. [6] Goethals I,Dierckx R,De Meerleer G,et al. The role of nuclear medicine in the prediction and detection of radiation-associated normal pulmonary and cardiac damage[J].J Nucl Med,2003,44(9):1531-1539. [7] Kumar G,Rawat S,Puri A,et al. Analysis of dose-volume parameters predicting radiation pneumonitis in patients with esophageal cancer treated with 3D-conformal radiation therapy or IMRT[J].Jpn J Radiol,2012,30(1):18-24.DOI:10.1007/s11604-011-0002-2. [8] De Jaeger K,Seppenwoolde Y,Boersma LJ,et al. Pulmonary function following high-dose radiotherapy of non-small-cell lung cancer[J].Int J Radiat Oncol Biol Phys,2003,55(5):1331-1340.DOI:10.1016/S0360-3016(02)04389-4. [9] Abratt RP,Willcox PA,Smith JA.Lung cancer in patients with borderline lung functions-zonal lung perfusion scans at presentation and lung function after high dose irradiation[J].Radiother Oncol,1990,19(4):317-322.DOI:10.1016/0167-8140(90)90031-Q. [10] Shioyama Y,Jang SY,Liu HH,et al. Preserving functional lung using perfusion imaging and intensity-modulated radiation therapy for advanced-stage non-small cell lung cancer[J].Int J Radiat Oncol Biol Phys,2007,68(5):1349-1358.DOI:10.1016/j.ijrobp.2007.02.015. [11] McGuire SM,Zhou SM,Marks LB,et al. A methodology for using SPECT to reduce intensity-modulated radiation therapy (IMRT) dose to functioning lung[J].Int J Radiat Oncol Biol Phys,2006,66(5):1543-1552.DOI:10.1016/j.ijrobp.2006.07.1377. [12] Wang SL,Liao ZX,Wei X,et al. Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT)[J].Int J Radiat Oncol Biol Phys,2006,66(5):1399-1407.DOI:10.1016/j.ijrobp.2006.07.1337. [13] Schallenkamp JM,Miller RC,Brinkmann DH,et al. Incidence of radiation pneumonitis after thoracic irradiation:dose-volume correlates[J].Int J Radiat Oncol Biol Phys,2007,67(2):410-416.DOI:10.1016/j.ijrobp.2006.09.030. [14] Menon C,Fraker DL.Tumor oxygenation status as a prognostic marker[J].Cancer Lett,2005,221(2):225-235.DOI:10.1016/j.canlet.2004.06.029.
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