Proton therapy radiation pneumonitis local dose-response in esophagus cancer patients.

Autor: Echeverria AE; The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., McCurdy M, Castillo R, Bernard V, Ramos NV, Buckley W, Castillo E, Liu P, Martinez J, Guerrero T
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2013 Jan; Vol. 106 (1), pp. 124-9. Date of Electronic Publication: 2012 Nov 02.
DOI: 10.1016/j.radonc.2012.09.003
Abstrakt: Purpose: This study quantifies pulmonary radiation toxicity in patients who received proton therapy for esophagus cancer.
Materials/methods: We retrospectively studied 100 esophagus cancer patients treated with proton therapy. The linearity of the enhanced FDG uptake vs. proton dose was evaluated using the Akaike Information Criterion (AIC). Pneumonitis symptoms (RP) were assessed using the Common Toxicity Criteria for Adverse Events version 4.0 (CTCAEv4). The interaction of the imaging response with dosimetric parameters and symptoms was evaluated.
Results: The RP scores were: 0 grade 4/5, 7 grade 3, 20 grade 2, 37 grade 1, and 36 grade 0. Each dosimetric parameter was significantly higher for the symptomatic group. The AIC winning models were 30 linear, 52 linear quadratic, and 18 linear logarithmic. There was no significant difference in the linear coefficient between models. The slope of the FDG vs. proton dose response was 0.022 for the symptomatic and 0.012 for the asymptomatic (p=0.014). Combining dosimetric parameters with the slope did not improve the sensitivity or accuracy in identifying symptomatic cases.
Conclusions: The proton radiation dose response on FDG PET/CT imaging exhibited a predominantly linear dose response on modeling. Symptomatic patients had a higher dose response slope.
(Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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