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Esophagus toxicity after stereotactic and hypofractionated radiotherapy for central lung tumors: Normal tissue complication probability modeling.

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Title: Esophagus toxicity after stereotactic and hypofractionated radiotherapy for central lung tumors: Normal tissue complication probability modeling.
Authors: Duijm, M.1 m.duijm@erasmusmc.nl, Tekatli, H.2, Oomen-De Hoop, E.1, Verbakel, W.2, Schillemans, W.1, Slotman, B.J.2, Senan, S.2, Nuyttens, J.J.1
Source: Radiotherapy & Oncology. May2018, Vol. 127 Issue 2, p233-238. 6p.
Subjects: Toxicity testing, Esophagus, Stereotactic radiotherapy, Lung tumors, Probability theory, Logistic regression analysis
Abstract: Purpose To correlate esophagus toxicity and dose-volume histogram (DVH) parameters in order to assess risks, and derive a Normal Tissue Complication Probability (NTCP) model. Methods and materials Patients with a central lung tumor from 2 centers, who underwent stereotactic or hypofractionated radiotherapy (≤12 fractions), were analyzed. Doses were recalculated to an equivalent dose of 2 Gy with an α/β ratio of 10 (EQD 2 10 ). The esophagus was manually delineated and DVH-parameters ( D max,EQD2 , D 1cc,EQD2 , D 2cc,EQD2 , D 5cc,EQD2 ) were analyzed and used for NTCP modeling based on logistic regression analysis. Results Two-hundred-and-thirty-one patients with 252 tumors were eligible. No acute or late grade 3–5 esophageal toxicity was reported. Acute grade 1–2 esophagus toxicity was recorded in 38 patients (17%). All DVH-parameters were significantly higher in patients with toxicity. NTCP models showed a 50% probability of acute grade 1–2 toxicity at a D max of 67 Gy EQD 2 10 and D 1cc of 42 Gy EQD 2 10 . No difference in overall survival was observed between patients with and without toxicity ( p  = 0.428). Conclusion As no grade 3–5 esophageal toxicity was observed in our cohort, a D max of 56 Gy EQD 2 10 and a D 5cc of 35.5 Gy EQD 2 10 could be delivered without high risks of severe toxicity. The NTCP models of this study might be used as practical guidelines for the treatment of central lung tumors with stereotactic radiotherapy. [ABSTRACT FROM AUTHOR]
Copyright of Radiotherapy & Oncology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Esophagus toxicity after stereotactic and hypofractionated radiotherapy for central lung tumors: Normal tissue complication probability modeling.
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  Data: <searchLink fieldCode="AR" term="%22Duijm%2C+M%2E%22">Duijm, M.</searchLink><relatesTo>1</relatesTo><i> m.duijm@erasmusmc.nl</i><br /><searchLink fieldCode="AR" term="%22Tekatli%2C+H%2E%22">Tekatli, H.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Oomen-De+Hoop%2C+E%2E%22">Oomen-De Hoop, E.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Verbakel%2C+W%2E%22">Verbakel, W.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Schillemans%2C+W%2E%22">Schillemans, W.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Slotman%2C+B%2EJ%2E%22">Slotman, B.J.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Senan%2C+S%2E%22">Senan, S.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Nuyttens%2C+J%2EJ%2E%22">Nuyttens, J.J.</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Radiotherapy+%26+Oncology%22">Radiotherapy & Oncology</searchLink>. May2018, Vol. 127 Issue 2, p233-238. 6p.
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  Data: <searchLink fieldCode="DE" term="%22Toxicity+testing%22">Toxicity testing</searchLink><br /><searchLink fieldCode="DE" term="%22Esophagus%22">Esophagus</searchLink><br /><searchLink fieldCode="DE" term="%22Stereotactic+radiotherapy%22">Stereotactic radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Lung+tumors%22">Lung tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Probability+theory%22">Probability theory</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink>
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  Data: Purpose To correlate esophagus toxicity and dose-volume histogram (DVH) parameters in order to assess risks, and derive a Normal Tissue Complication Probability (NTCP) model. Methods and materials Patients with a central lung tumor from 2 centers, who underwent stereotactic or hypofractionated radiotherapy (≤12 fractions), were analyzed. Doses were recalculated to an equivalent dose of 2 Gy with an α/β ratio of 10 (EQD 2 10 ). The esophagus was manually delineated and DVH-parameters ( D max,EQD2 , D 1cc,EQD2 , D 2cc,EQD2 , D 5cc,EQD2 ) were analyzed and used for NTCP modeling based on logistic regression analysis. Results Two-hundred-and-thirty-one patients with 252 tumors were eligible. No acute or late grade 3–5 esophageal toxicity was reported. Acute grade 1–2 esophagus toxicity was recorded in 38 patients (17%). All DVH-parameters were significantly higher in patients with toxicity. NTCP models showed a 50% probability of acute grade 1–2 toxicity at a D max of 67 Gy EQD 2 10 and D 1cc of 42 Gy EQD 2 10 . No difference in overall survival was observed between patients with and without toxicity ( p  = 0.428). Conclusion As no grade 3–5 esophageal toxicity was observed in our cohort, a D max of 56 Gy EQD 2 10 and a D 5cc of 35.5 Gy EQD 2 10 could be delivered without high risks of severe toxicity. The NTCP models of this study might be used as practical guidelines for the treatment of central lung tumors with stereotactic radiotherapy. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Radiotherapy & Oncology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: May2018
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