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Strahlentherapie und Onkologie

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01-09-2020 | Esophageal Cancer | Original Article

Effect of lung volume on helical radiotherapy in esophageal cancer: are there predictive factors to achieve acceptable lung doses?

Authors: Meltem Kirli Bolukbas, M.D., Sibel Karaca, Ph.D.

Published in: Strahlentherapie und Onkologie | Issue 9/2020

Abstract

Purpose

The dose received by the lungs in radiotherapy (RT) is affected by the patient’s current lung volume. The presence of predictive factors and cut-off points were investigated to achieve acceptable lung doses in esophageal cancer (EC) treatment.

Methods

Virtual RT volumes of supracarinal EC were delineated. RT plans were designed with standard criteria in the TomoTherapy planning system (TomoTherapy Inc., Madison, WI, USA). The total dose was 50.4 Gy (1.8 Gy/fraction). ROC (Receiver operating characteristic) analysis and Mann–Whitney U tests were performed.

Results

There was a total of 65 patient plans included. ROC analysis showed that lung/PTV (Planning target volume) volume ratio (AUC [Area under curve]: 0.91, 95% CI: 0.83–0.99, p = 0.000) and bilateral lung volume (AUC: 0.81, 95% CI: 0.70–0.92, p = 0.000) have diagnostic power to predict the suitability of RT plans according to QUANTEC (Quantitative Analyses of Normal Tissue Effects in the Clinic) for lung dose constraints. The cut-off points of 7 and 3500 cc were selected for lung/PTV ratio and bilateral lung volume, respectively. The effect of the cut-off points on the dose data was assessed with the Mann–Whitney U test. The mean lung and heart doses, lung V5, V15, and V20, as well as heart V5, V20, V30, and V45 values were found to be lower in both groups separated by cut-off points (p < 0.05).

Conclusion

The lung/PTV ratio ≥7 and bilateral lung volume ≥3500 cc cut-off points are predictive of whether TomoTherapy plans may meet QUANTEC lung dose limits in patients with supracarinal esophageal cancer. The patients with lung/PTV ratio and lung volume above these cut-off points may be candidates for treatment with TomoTherapy.

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Title: Effect of lung volume on helical radiotherapy in esophageal cancer: are there predictive factors to achieve acceptable lung doses?
Authors: Meltem Kirli Bolukbas, M.D.
Sibel Karaca, Ph.D.
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: Esophageal Cancer
Esophageal Cancer
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 9/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01581-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effect of lung volume on helical radiotherapy in esophageal cancer: are there predictive factors to achieve acceptable lung doses?

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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