Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC)
Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC)
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DOI：
10.1016/s0360-3016(99)00183-2
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发表时间：
1999-09-01
影响因子：
7
通讯作者：
Perez, CA
中科院分区：
文献类型：
--
作者：
Graham, MV;Purdy, JA;Perez, CA
目的：确定一个临床相关且可用的参数，用于识别非小细胞肺癌（NSCLC）患者在接受三维（3D）放射治疗时发生肺炎的风险。方法与材料：1991年1月至1995年10月，99例不能手术的非小细胞肺癌患者接受了明确的治疗。选择表现良好（96%）和没有体重减轻（82%）的患者。所有患者在治疗前都有完整的3D治疗计划（包括总肺剂量-体积直方图[DVHs]）。比较治疗后肺总DVH参数与肺炎的发生率和分级。结果：单因素分析显示，肺总容积超过20 Gy （V-20）的百分比、有效容积（V-eff）和肺总容积平均剂量、肿瘤原发部位（上肺叶vs下肺叶）与大于或等于2级肺炎的发展有统计学意义。多变量分析显示，V-20是肺炎的单一独立预测因子。结论：全肺DVH的V-20是一个很容易从大多数三维治疗计划系统中获得的有用参数。V-20可能有助于比较相互竞争的治疗方案，以评估我们个体患者治疗的肺炎风险，也可能是对患者分层或前瞻性剂量递增试验的有用参数。(C) 1999 Elsevier Science Inc.；
Purpose: To identify a clinically relevant and available parameter upon which to identify non-small cell lung cancer (NSCLC) patients at risk for pneumonitis when treated with three-dimensional (3D) radiation therapy.Methods and Materials: Between January 1991 and October 1995, 99 patients were treated definitively for inoperable NSCLC. Patients were selected for good performance status (96%) and absence of weight loss (82%). All patients had full 3D treatment planning (including total lung dose-volume histograms [DVHs]) prior to treatment delivery. The total lung DVH parameters were compared with the incidence and grade of pneumonitis after treatment.Results: Univariate analysis revealed the percent of the total lung volume exceeding 20 Gy (V-20), the effective volume (V-eff) and the total lung volume mean dose, and location of the tumor primary (upper versus lower lobes) to be statistically significant relative to the development of greater than or equal to Grade 2 pneumonitis. Multivariate analysis revealed the V-20 to be the single independent predictor of pneumonitis.Conclusions: The V-20 from the total lung DVH is a useful parameter easily obtained from most 3D treatment planning systems. The V-20 may be useful in comparing competing treatment plans to evaluate the risk of pneumonitis for our individual patient treatment and may also be a useful parameter upon which to stratify patients or prospective dose escalation trials. (C) 1999 Elsevier Science Inc.