Abstract | PURPOSE: METHODS AND MATERIALS: In the study, 160 (78 photon, 82 proton) patients with LA-NSCLC treated with chemoradiotherapy between 2011 and 2016 were retrospectively identified. Forty (20 photon, 20 proton) patients exhibited grade ≥2 RP after therapy. Dose volume histograms for the uninvolved lung were extracted for each patient. The percent lung volumes receiving above various dose levels were obtained in addition to V20Gy and Dmean. These dosimetric parameters and patient characteristics were evaluated with univariate and multivariate logistic regression tests. Receiver operating characteristic curves were generated to obtain the optimal dosimetric constraints through analyzing RP and non-RP sensitivity and specificity values. RESULTS: The multivariate analysis showed V40Gy and Dmean to be statistically significant for proton and photon patients, respectively. V35Gy to V50Gy were strongly correlated to V40Gy for proton patients. Based on the receiver operating characteristic curves, V35Gy to V50Gy had the highest area under the curve compared with other dose levels for proton patients. A potential dosimetric constraint for RP predictor in proton patients is V40Gy ≤ 23%. CONCLUSIONS: In addition to V20Gy and Dmean, the lung volume receiving higher doses, such as V40Gy, may be used as an additional indicator for RP in LA-NSCLC patients treated with proton therapy.
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Authors | Wendy B Harris, Wei Zou, Chingyun Cheng, Varsha Jain, Boon-Keng Kevin Teo, Lei Dong, Steven J Feigenberg, Abigail T Berman, William P Levin, Keith A Cengel, Shannon E O'Reilly |
Journal | Advances in radiation oncology
(Adv Radiat Oncol)
2020 Sep-Oct
Vol. 5
Issue 5
Pg. 943-950
ISSN: 2452-1094 [Print] United States |
PMID | 33083657
(Publication Type: Journal Article)
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Copyright | © 2020 The Authors. |