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- W2016073193 abstract "In stereotactic ablative radiation therapy (SABR), high doses per fraction are delivered so that the desired target receives the prescribed dose, with a minimal excess volume and a sharp dose fall-off outside the target volume. The purpose of this study is to evaluate the relationship between the conformity index (CI), the homogeneity index (HI), and the conformity gradient index (CGI) and the development of radiation pneumonitis (RP) in early stage non small cell lung cancer (NSCLC) patients treated with SABR delivered by Helical Tomotherapy (HT). From May 2009 to May 2011, nine consecutive I-IIA stage NSCLC patients with a median age of 75 years (range, 70 to 79) underwent SABR with HT. Patients were treated with 60 Gy at 12 Gy/fraction (n = 7) or 7.5 Gy/fraction (n = 2). Median follow-up time was 16 months (range, 8 to 40). Clinical toxicity was scored using the CTC v3.0. CI was assessed according the RTOG (CIRTOG = [Volume of the reference isodose]/[Target volume]) and Paddick (CIPaddick = [Target volume covered by the reference isodose]/ [Target volume * Volume of the reference isodose]) criteria. HI was evaluated according the RTOG criteria (HIRTOG = [Maximum isodose in the target]/[Reference isodose]). Finally, the CGI was defined as [(Target volume)/(Volume of the reference isodose)]*100. Data were analyzed by using Spearman's correlation test. Median planning target volume (PTV) was 68 cc (range, 41-157). Mean lung dose (MLD) was 6Gy. Median lung volume receiving 5 (V5) and 20 Gy (V20) was 43% and 24%, respectively, for the ipsilateral lung; and 5% and 0.3%, respectively, for the contralateral lung. The average dose conformity and homogeneity index values were 1.25 +/-0.06 and 1.15 +/-0.05, respectively. CGI ranged from 75 to 88 (average 84). A greater PTV was correlated with a better CIPaddick (r = 0.83: P = 0.006) and CIRTOG (r = 0,98; P <0.0001). A better HIRTOG was correlated with a lower total lung V20 (r = 0.78:P = 0.013) and a lower contralateral lung V20 (r = 0.79:P = 0.011). Eight patients experienced RP: 6 had Grade 1 RP and 2 had Grade 2 RP. A higher RP was correlated with a higher contralateral lung V20 (r = 0.79:P = 0.012) or a worse HIRTOG (r = 0.69:P = 0.04). In addition, a higher PTV was marginally correlated with a higher RP (r = 0.62: P = 0.076). Finally, a better CGI was correlated with a higher RP (r = 0.76: P = 0.018). The HI and the CGI correlated with RP in early stage NSCLC patients treated with SABR delivered by HT, the better the HI, the lower the RP Grade; and the better the CGI, the higher the RP Grade. Additionally, a higher contralateral lung V20 was correlated with a higher RP Grade. If validated in a larger population, this information should help to design treatment plans for patients who are at high risk of toxicity." @default.
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- W2016073193 date "2012-11-01" @default.
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- W2016073193 title "Stereotactic Ablative Radiation Therapy Delivered by Helical Tomotherapy for Early-Stage Non-small Cell Lung Cancer: Dosimetric Evaluation and Toxicity" @default.
- W2016073193 doi "https://doi.org/10.1016/j.ijrobp.2012.07.2194" @default.
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