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Correlation of Dosimetric Parameters Obtained with the Analytical Anisotropic Algorithm and Toxicity of Chest Chemoradiation in Lung Carcinoma.
MedLine Citation:
PMID:  21925864     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The purpose of this study was to analyze and revisit toxicity related to chest chemoradiotherapy and to correlate these side effects with dosimetric parameters obtained using analytical anisotropic algorithm (AAA) in locally unresectable advanced lung cancer. We retrospectively analyzed data from 47 lung cancer patients between 2005 and 2008. All received conformal 3D radiotherapy using high-energy linear accelerator plus concomitant chemotherapy. All treatment planning data were transferred into Eclipse 8.05 (Varian Medical Systems, Palo Alto, CA) and dosimetric calculations were performed using AAA. Thirty-three patients (70.2%) developed acute pneumopathy after radiotherapy (grades 1 and 2). One patient (2.1%) presented with grade 3 pneumopathy. Thirty-one (66%) presented with grades 1-2 lung fibrosis, and 1 patient presented with grade 3 lung fibrosis. Thirty-four patients (72.3%) developed grade 1-2 acute oesophagic toxicity. Four patients (8.5%) presented with grades 3 and 4 dysphagia, necessitating prolonged parenteral nutrition. Median prescribed dose was 64 Gy (range 50-74) with conventional fractionation (2 Gy per fraction). Dose-volume constraints were respected with a median V20 of 23.5% (maximum 34%) and a median V30 of 17% (maximum 25%). The median dose delivered to healthy contralateral lung was 13.1 Gy (maximum 18.1 Gy). At univariate analysis, larger planning target volume and V20 were significantly associated with the probability of grade ≥2 radiation-induced pneumopathy (p = 0.022 and p = 0.017, respectively). No relation between oesophagic toxicity and clinical/dosimetric parameters could be established. Using AAA, the present results confirm the predictive value of the V20 for lung toxicity as already demonstrated with the conventional pencil beam convolution approach.
Authors:
Lysian Cartier; Pierre Auberdiac; Mustapha Khodri; Nadia Malkoun; Cyrus Chargari; Julie Thorin; Adrien Mélis; Jean-Noël Talabard; Guy de Laroche; Pierre Fournel; Olivier Tiffet; Thierry Schmitt; Nicolas Magné
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-16
Journal Detail:
Title:  Medical dosimetry : official journal of the American Association of Medical Dosimetrists     Volume:  -     ISSN:  1873-4022     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908862     Medline TA:  Med Dosim     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
Affiliation:
Dèpartement de Radiothérapie, Institut de Cancérologie de la Loire, St-Priest en Jarez, France.
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