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Medicina (Kaunas). 2006;42(4):314-20.

[Importance of dosimetric factors predicting radiation toxicity in lung cancer treatment].

[Article in Lithuanian]

Author information

1
Clinic of Conservative Tumor Treatment, Institute of Oncology, Vilnius University, Vilnius, Lithuania. simona.letautiene@gmail.com

Abstract

OBJECTIVE:

To evaluate prognostic importance of dosimetric parameters (V20, V30 and V40) in the incidence of lung radiation toxicity caused by external-beam radiation therapy in patients with lung cancer.

MATERIAL AND METHODS:

A total of 82 patients with lung cancer were analyzed prospectively. They were treated in the Oncology Institute of Vilnius University from 2002 to 2005. Three-dimensional conformal radiotherapy was administered to all patients; radiation dose was > or =50 Gy, delivered in daily fractions of 2 Gy. All patients received concurrent chemotherapy and part of them - surgery. All patients were evaluated before radiation therapy and after 3-, 6-, and 12-month follow-up. V20, V30, and V40 were calculated from dose-volume histograms using the Eclipse(TM) radiotherapy treatment planing system. Based on radiological findings and clinical symptoms radiation-induced lung injury (radiation pneumonitis and radiation fibrosis) was diagnosed.

RESULTS:

Nearly half of patients (48%) developed grade < or =2 pulmonary toxicity according to the Subjective, Objective, Management and Analytic/Late Effects on Normal Tissues (SOMA/LENT) scale. The percentage volume of normal lung tissue receiving >20 Gy dose was 38%, >30 Gy--25%, and >40 Gy--18%. In patients free of radiation toxicity V20 was 30%, V30--22%, and V40--18%, and in patients with radiation-induced pulmonary toxicity V20 was 48%, V30--30%, and V40--18%.

CONCLUSIONS:

Dosimetric parameters V20, V30, and V40 are significant predictive factors for radiation-induced pulmonary toxicity. At this time planned V20 and V30 are too high and they should be minimized in order to reduce radiation-induced pulmonary toxicity.

PMID:
16687903
[Indexed for MEDLINE]
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