Dose-averaged linear energy transfer within the gross tumor volume of non-small-cell lung cancer affects the local control in carbon-ion radiotherapy.

Autor: Li G; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China. Electronic address: lgs13569277160@163.com., Ma N; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China., Wang W; Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China., Chen J; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China., Mao J; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China., Jiang G; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China., Wu K; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China; Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai 201315, China. Electronic address: Kailiang.wu@sphic.org.cn.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Dec; Vol. 201, pp. 110584. Date of Electronic Publication: 2024 Oct 14.
DOI: 10.1016/j.radonc.2024.110584
Abstrakt: Background and Purpose: High linear energy transfer (LET) radiation exhibits stronger tumor-killing effect. However, the correlation between LET and the therapeutic efficacy in Carbon-ion radiotherapy (CIRT) for locally advanced non-small-cell lung cancer (LA-NSCLC) is currently not clear. This study aimed to investigate the relationship between the dose-averaged LET (LET d ) distribution within tumor and local recurrence for LA-NSCLC treated with CIRT.
Methods and Materials: An analysis of 62 consecutive patients with LA-NSCLC who underwent CIRT from 2018 to 2022 was conducted. The LET d distribution was calculated based on their treated plans, and the correlation between local recurrence and LET d , relative biological effectiveness (RBE)-weighted doses (D RBE ) and clinical factors was investigated. Receiver operating characteristic (ROC) curve, log-rank test, and Cox regression analysis were performed based on that.
Results: 16 patients were defined as local recurrence. Overall survival (OS) and local control (LC) at 24 months were 76.9 % and 73.2 %, respectively. The mean LET d in internal gross tumor volume (iGTV) in the local recurrence group was 48.7 keV/µm, significantly lower than the mean LET d of 53.2 keV/µm in the local control group (p = 0.016). No significant difference was observed in D RBE between the local recurrence and local control groups. ROC curve analysis indicated that a percentage of 88 % of volume in iGTV receiving at least 40 keV/µm (V 40keV/μm ) is the optimal threshold for predicting local recurrence (Area under curve (AUC) = 0.7636). The log-rank test and Cox regression analysis revealed that the LET d value covering 98 % volume of iGTV (LET d 98%) was a significant risk factor for LC (p = 0.020).
Conclusions: Our study revealed an association between LET d distribution and local recurrence in patients with LA-NSCLC. These findings suggest that lower LET d may increase the probability of local recurrence. We suggest that LET d distribution within iGTV should be routinely assessed in CIRT for lung cancer.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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