Probing thoracic dose patterns associated to pericardial effusion and mortality in patients treated with photons and protons for locally advanced non-small-cell lung cancer
| Autor: | Raffaele Liuzzi, Laura Cella, Giuseppe Palma, Ting Xu, Radhe Mohan, Serena Monti, Marco Durante, Zhongxing Liao, Arnaldo Stanzione |
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| Přispěvatelé: | Cella, L., Monti, S., Xu, T., Liuzzi, R., Stanzione, A., Durante, M., Mohan, R., Liao, Z., Palma, G. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Thorax
medicine.medical_specialty Lung Neoplasms Non-Small-Cell Lung Cancer Locally advanced Pericardial effusion Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Voxel based analysis medicine Proton Therapy Humans Radiology Nuclear Medicine and imaging In patient Intensity modulated photon radiotherapy Lung cancer Proton therapy Photons business.industry Proportional hazards model Passive scattering proton therapy Radiotherapy Dosage Hematology medicine.disease Photon Lung Neoplasm Oncology 030220 oncology & carcinogenesis Voxel based analysi Radiology Non small cell Proton Radiotherapy Intensity-Modulated Protons business Human |
| Zdroj: | Radiotherapy and oncology 160 (2021): 148–158. doi:10.1016/j.radonc.2021.04.025 info:cnr-pdr/source/autori:Cella, Laura; Monti, Serena; Xu, Ting; Liuzzi, Raffaele; Stanzione, Arnaldo; Durante, Marco; Mohan, Radhe; Liao, Zhongxing; Palma, Giuseppe/titolo:Probing thoracic dose patterns associated to pericardial effusion and mortality in patients treated with photons and protons for locally advanced non-small-cell lung cancer/doi:10.1016%2Fj.radonc.2021.04.025/rivista:Radiotherapy and oncology/anno:2021/pagina_da:148/pagina_a:158/intervallo_pagine:148–158/volume:160 Radiother Oncol |
| DOI: | 10.1016/j.radonc.2021.04.025 |
| Popis: | Purpose To investigate thoracic dose–response patterns for pericardial effusion (PCE) and mortality in patients treated for locally advanced Non-Small-Cell Lung Cancer (NSCLC) by Intensity Modulated RT (IMRT) or Passive-Scattering Proton Therapy (PSPT). Methods Among 178 patients, 43.5% developed grade ≥ 2 PCE. Clinical and dosimetric factors associated with PCE or overall survival (OS) were identified via multi-variable Cox proportional hazards modeling. The Voxel-Based Analyses (VBAs) of local dose differences between patients with and without PCE and mortality was performed. The robustness of VBA results was assessed by a novel characterization of spatial properties of dose distributions based on probabilistic independent component analysis (PICA) and connectograms. Results Several non-dosimetric variables were selected by the multivariable analysis for the considered outcomes, while the time-dependent PCE onset was uncorrelated with the OS (p = 0.34) at a multi-variable Cox analysis. Despite the significant PSPT dosimetric advantage, the RT technique did not affect the occurrence of PCE or OS. VBAs highlighted largely overlapping clusters significantly associated with PCE endpoints in heart and lungs. No significant dosimetric patterns related to mortality endpoints were found. PICA identified 43 components homogeneously scattered within thorax, while connectograms showed modest correlations between doses in main cardio-pulmonary substructures. Conclusions Spatially resolved analysis highlighted dose patterns related to radiation-induced cardiac toxiciy and the observed organ-based dose–response mismatch in PSPT and IMRT. Indeed, the thoracic regions spared by PSPT poorly overlapped with the areas involved in PCE development, as highlited by VBA. PICA and connectograms proved valuable tools for assessing the robusteness of obtained VBA inferences. |
| Databáze: | OpenAIRE |
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