Chest Wall Volume Receiving >30 Gy Predicts Risk of Severe Pain and/or Rib Fracture After Lung Stereotactic Body Radiotherapy

医学 放射治疗 毒性 核医学 放射治疗计划 外围设备 肺容积 外科 放射科 内科学
作者
Neal E. Dunlap,Jing Cai,Gregory Biedermann,Wensha Yang,Stanley Benedict,Ke Sheng,Tracey E. Schefter,Brian D. Kavanagh,James M. Larner
出处
期刊:International Journal of Radiation Oncology Biology Physics [Elsevier BV]
卷期号:76 (3): 796-801 被引量:267
标识
DOI:10.1016/j.ijrobp.2009.02.027
摘要

Purpose To identify the dose–volume parameters that predict the risk of chest wall (CW) pain and/or rib fracture after lung stereotactic body radiotherapy. Methods and Materials From a combined, larger multi-institution experience, 60 consecutive patients treated with three to five fractions of stereotactic body radiotherapy for primary or metastatic peripheral lung lesions were reviewed. CW pain was assessed using the Common Toxicity Criteria for pain. Peripheral lung lesions were defined as those located within 2.5 cm of the CW. A minimal point dose of 20 Gy to the CW was required. The CW volume receiving ≥20, ≥30, ≥40, ≥50, and ≥60 Gy was determined and related to the risk of CW toxicity. Results Of the 60 patients, 17 experienced Grade 3 CW pain and five rib fractures. The median interval to the onset of severe pain and/or fracture was 7.1 months. The risk of CW toxicity was fitted to the median effective concentration dose–response model. The CW volume receiving 30 Gy best predicted the risk of severe CW pain and/or rib fracture (R2 = 0.9552). A volume threshold of 30 cm3 was observed before severe pain and/or rib fracture was reported. A 30% risk of developing severe CW toxicity correlated with a CW volume of 35 cm3 receiving 30 Gy. Conclusion The development of CW toxicity is clinically relevant, and the CW should be considered an organ at risk in treatment planning. The CW volume receiving 30 Gy in three to five fractions should be limited to <30 cm3, if possible, to reduce the risk of toxicity without compromising tumor coverage. To identify the dose–volume parameters that predict the risk of chest wall (CW) pain and/or rib fracture after lung stereotactic body radiotherapy. From a combined, larger multi-institution experience, 60 consecutive patients treated with three to five fractions of stereotactic body radiotherapy for primary or metastatic peripheral lung lesions were reviewed. CW pain was assessed using the Common Toxicity Criteria for pain. Peripheral lung lesions were defined as those located within 2.5 cm of the CW. A minimal point dose of 20 Gy to the CW was required. The CW volume receiving ≥20, ≥30, ≥40, ≥50, and ≥60 Gy was determined and related to the risk of CW toxicity. Of the 60 patients, 17 experienced Grade 3 CW pain and five rib fractures. The median interval to the onset of severe pain and/or fracture was 7.1 months. The risk of CW toxicity was fitted to the median effective concentration dose–response model. The CW volume receiving 30 Gy best predicted the risk of severe CW pain and/or rib fracture (R2 = 0.9552). A volume threshold of 30 cm3 was observed before severe pain and/or rib fracture was reported. A 30% risk of developing severe CW toxicity correlated with a CW volume of 35 cm3 receiving 30 Gy. The development of CW toxicity is clinically relevant, and the CW should be considered an organ at risk in treatment planning. The CW volume receiving 30 Gy in three to five fractions should be limited to <30 cm3, if possible, to reduce the risk of toxicity without compromising tumor coverage.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
干雅柏完成签到,获得积分10
刚刚
八九完成签到,获得积分10
1秒前
2秒前
干雅柏发布了新的文献求助10
3秒前
Stardust发布了新的文献求助10
3秒前
黑白和完成签到 ,获得积分10
4秒前
yang完成签到,获得积分10
5秒前
金蛋蛋发布了新的文献求助10
6秒前
量子星尘发布了新的文献求助10
8秒前
12秒前
17秒前
淡定的电源完成签到,获得积分10
20秒前
20秒前
lm发布了新的文献求助10
23秒前
25秒前
善学以致用应助孤独问旋采纳,获得10
25秒前
孙燕应助霸气安筠采纳,获得30
26秒前
李健应助科研通管家采纳,获得10
26秒前
汉堡包应助科研通管家采纳,获得10
26秒前
SYLH应助科研通管家采纳,获得20
26秒前
SYLH应助科研通管家采纳,获得10
26秒前
上官若男应助科研通管家采纳,获得10
26秒前
烟花应助科研通管家采纳,获得10
26秒前
丘比特应助科研通管家采纳,获得10
26秒前
SYLH应助科研通管家采纳,获得10
27秒前
CAOHOU应助科研通管家采纳,获得10
27秒前
SYLH应助科研通管家采纳,获得10
27秒前
CAOHOU应助科研通管家采纳,获得10
27秒前
SYLH应助科研通管家采纳,获得10
27秒前
科研通AI2S应助科研通管家采纳,获得10
27秒前
JamesPei应助科研通管家采纳,获得10
27秒前
ding应助科研通管家采纳,获得10
27秒前
27秒前
SYLH应助科研通管家采纳,获得10
27秒前
CAOHOU应助科研通管家采纳,获得10
27秒前
SYLH应助科研通管家采纳,获得20
27秒前
27秒前
29秒前
nbing完成签到,获得积分10
30秒前
十月的天空完成签到,获得积分10
31秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989378
求助须知:如何正确求助?哪些是违规求助? 3531442
关于积分的说明 11254002
捐赠科研通 3270126
什么是DOI,文献DOI怎么找? 1804887
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809173