Regression models for predicting physical and EQD2 plan parameters of two methods of hybrid planning for stage III NSCLC

Radiation Oncology - Tập 16 - Trang 1-13 - 2021
Hao Wang1,2, Yongkang Zhou3, Wutian Gan4, Hua Chen2, Ying Huang2, Yanhua Duan2, Aihui Feng2, Yan Shao2, Hengle Gu2, Qing Kong1, Zhiyong Xu2
1Institute of Modern Physics, Fudan University, Shanghai, China
2Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
3Department of Radiation Oncology, Zhongshan Hospital, Shanghai, China
4School of Physics and Technology, University of Wuhan, Wuhan, China

Tóm tắt

To establish regression models of physical and equivalent dose in 2 Gy per fraction (EQD2) plan parameters of two kinds of hybrid planning for stage III NSCLC. Two kinds of hybrid plans named conventional fraction radiotherapy & stereotactic body radiotherapy (C&S) and conventional fraction radiotherapy & simultaneous integrated boost (C&SIB) were retrospectively made for 20 patients with stage III NSCLC. Prescription dose of C&S plans was 2 Gy × 30f for planning target volume of lymph node (PTVLN) and 12.5 Gy × 4f for planning target volume of primary tumor (PTVPT), while prescription dose of C&SIB plans was 2 Gy × 26f for PTVLN and sequential 2 Gy × 4f for PTVLN combined with 12.5 Gy × 4f for PTVPT. Regression models of physical and EQD2 plan parameters were established based on anatomical geometry features for two kinds of hybrid plans. The features were mainly characterized by volume ratio, min distance and overlapping slices thickness of two structures. The possibilities of regression models of EQD2 plan parameters were verified by spearman’s correlation coefficients between physical and EQD2 plan parameters, and the influence on the consistence of fitting goodness between physical and EQD2 models was investigated by the correlations between physical and EQD2 plan parameters. Finally, physical and EQD2 models predictions were compared with plan parameters for two new patients. Physical and EQD2 plan parameters of PTVLN CI60Gy have shown strong positive correlations with PTVLN volume and min distance(PT to LN), and strong negative correlations with PTVPT volume for two kinds of hybrid plans. PTV(PT+LN) CI60Gy is not only correlated with above three geometry features, but also negatively correlated with overlapping slices thickness(PT and LN). When neck lymph node metastasis was excluded from PTVLN volume, physical and EQD2 total lung V20 showed a high linear correlation with corrected volume ratio(LN to total lung). Meanwhile, physical total lung mean dose (MLD) had a high linear correlation with corrected volume ratio(LN to total lung), while EQD2 total lung MLD was not only affected by corrected volume ratio(LN to total lung) but also volume ratio(PT to total lung). Heart D5, D30 and mean dose (MHD) would be more susceptible to overlapping structure(heart and LN). Min distance(PT to ESO) may be an important feature for predicting EQD2 esophageal max dose for hybrid plans. It’s feasible for regression models of EQD2 plan parameters, and the consistence of the fitting goodness of physical and EQD2 models had a positive correlation with spearman’s correlation coefficients between physical and EQD2 plan parameters. For total lung V20, ipsilateral lung V20, and ipsilateral lung MLD, the models could predict that C&SIB plans were higher than C&S plans for two new patients. The regression models of physical and EQD2 plan parameters were established with at least moderate fitting goodness in this work, and the models have a potential to predict physical and EQD2 plan parameters for two kinds of hybrid planning.

Tài liệu tham khảo

Curran WJ Jr, Paulus R, Langer CJ, et al. Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410. J Natl Cancer Inst. 2011;103(19):145–60. Fournel P, Robinet G, Thomas P, et al. Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-saint-Etienne d’Oncologie Thoracique-Groupe Francais de PneumoCancerologie NPC 95–01 study. J Clin Oncol. 2005;23(25):5910–7. Huber RM, Flentje M, Schmidt M, et al. Simultaneous chemoradiotherapy compared with radiotherapy alone after induction chemotherapy in inoperable stage IIIA or IIIB non–small-cell lung cancer: study CTRT99/97 by the bronchial carcinoma therapy group. J Clin Oncol. 2006;24(27):4397–404. van Diessen JN, Chen C, van den Heuvel MM, Belderbos JS, Sonke JJ. Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy. Radiother Oncol. 2016;118:447–52. Schytte T, Nielsen TB, Brink C, Hansen O. Pattern of loco-regional failure after defifinitive radiotherapy for non-small cell lung cancer. Acta Oncol. 2014;53:336–41. Ball D, Mai T, Vinod S, et al. MA 13.07 a randomized trial of SABR vs conventional radiotherapy for inoperable stage I non-small cell lung Cancer: TROG09.02 (CHISEL). J Thorac Oncol. 2017;12(11):S1853. Feddock J, Arnold SM, Shelton BJ, Sinha P, Conrad G, Chen L, et al. Stereotactic body radiation therapy can be used safely to boost residual disease in locally advanced non-small cell lung cancer: a prospective study. Int J Radiat Oncol Biol Phys. 2013;85:1325–31. Hepel JT, Leonard KL, Safran H, Ng T, Taber A, Khurshid H, et al. Stereotactic body radiation therapy boost after concurrent chemoradiation for locally advanced non-small cell lung cancer: a phase 1 dose escalation study. Int J Radiat Oncol Biol Phys. 2016;96:1021–7. Higgins KA, Pillai RN, Chen Z, Tian S, Zhang C, Patel P, et al. Concomitant chemotherapy and radiotherapy with SBRT boost for unresectable stage III non-small cell lung cancer: a phase I study. J Thorac Oncol. 2017;12:1687–95. Karam SD, Horne ZD, Hong RL, McRae D, Duhamel D, Nasr NM. Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer. Radiat Oncol. 2013;8:179. Yeon JK, Su SK, Si YS, Eun KC. Feasibility of stereotactic radiotherapy for lung lesions and conventional radiotherapy for nodal areas in primary lung Malignancies. Radiat Oncol. 2018;13:127. Peulen H, Franssen G, Belderbos J, van der Bijl E, Tijhuis A, Rossi M, Sonke J-J, Damen E. SBRT combined with concurrent chemoradiation in stage III NSCLC: Feasibility study of the phase I Hybrid trial. Radiother Oncol. 2020;142:224–9. Wang H, Chen H, Gu HL, et al. A novel IMRT planning study by using the fixed-jaw method in the treatment of peripheral lung cancer with mediastinal lymph node metastasis. Med Dos. 2018;43(1):46–54. Haasbeek CJ, Lagerwaard FJ, Antonisse ME, Slotman BJ, Senan S. Stage I nonsmall cell lung cancer in patients aged > or =75 years: outcomes after stereotactic radiotherapy. Cancer. 2010;116(2):406–14. Steel GG. Basic clinical radiobiology. 3rd ed. London: Oxford University Press lnc; 2002. Park C, Papiez L, Zhang S, Story M, Timmerman RD. Universal survival curve and single fraction equivalent dose: useful tools in understanding potency of ablative radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70:847–52. Ueyama T, Arimura T, Takumi K, Nakamura F, et al. Risk factors for radiation pneumonitis after stereotactic radiation therapy for lung tumours: Clinical usefulness of the planning target volume to total lung volume ratio. Br J Radiol. 2018;91(1086):20170453. Bolukbas MK, Karaca S. Effect of lung volume on helical radiotherapy in esophageal cancer: are there predictive factors to achieve acceptable lung doses? Strahlenther Onkol. 2020;196(9):805–12. Hof SV, Delaney AR, Tekatli H, Twisk J, Slotman BJ, Senan S, Dahele M, Verbakel WFAR. Knowledge-based planning for identifying high-risk stereotactic ablative radiation therapy treatment plans for lung tumors larger than 5 cm. Int J Radiat Oncol Biol Phys. 2019;103(1):259–67. Kavanaugh JA, Holler S, DeWees TA, Robinson CG, Bradley JD, et al. Multi-institutional validation of a knowledge-based planning model for patients enrolled in rtog 0617: implications for plan quality controls in cooperative group trials. Pract Radiat Oncol. 2019;9(2):e218–27.