Changes in Global Function and Regional Ventilation and Perfusion on SPECT During the Course of Radiotherapy in Patients With Non-Small-Cell Lung Cancer
Autor: | Khaled A. Hassan, S. Yuan, D. Arenberg, Jean M. Moran, James A. Hayman, Nithya Ramnath, Milton D. Gross, Xu-Wei Cai, Kirk A. Frey, Feng-Ming Spring Kong, Avraham Eisbruch, Randall K. Ten Haken |
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Rok vydání: | 2012 |
Předmět: |
Male
Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Vital Capacity Single-photon emission computed tomography Ventilation/perfusion ratio Article Pulmonary function testing Carcinoma Non-Small-Cell Lung Forced Expiratory Volume medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Lung cancer Lung Aged Aged 80 and over Tomography Emission-Computed Single-Photon Radiation medicine.diagnostic_test business.industry Respiration Radiotherapy Dosage Common Terminology Criteria for Adverse Events Middle Aged medicine.disease Radiation therapy Dyspnea Oncology Pulmonary Diffusing Capacity Female Radiology business Organ Sparing Treatments Perfusion Emission computed tomography |
Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 82:e631-e638 |
ISSN: | 0360-3016 |
Popis: | This study aimed to (1) examine changes in dyspnea, global pulmonary function test (PFT) results, and functional activity on ventilation (V)/perfusion (Q) single-photon emission computerized tomography (SPECT) scans during the course of radiation (RT), and (2) factors associated with the changes in patients with non-small-cell lung cancer (NSCLC).Fifty-six stage I to III NSCLC patients treated with definitive RT with or without chemotherapy were enrolled prospectively. Dyspnea was graded according to Common Terminology Criteria for Adverse Events version 3.0 prior to and weekly during RT. V/Q SPECT-computed tomography (CT) and PFTs were performed prior to and during RT at approximately 45 Gy. Functions of V and Q activities were assessed using a semiquantitative scoring of SPECT images.Breathing improved significantly at the third week (mean dyspnea grade, 0.8 vs. 0.6; paired t-test p = 0.011) and worsened during the later course of RT (p0.05). Global PFT results did not change significantly, while regional lung function on V/Q SPECT improved significantly after ∼45 Gy. The V defect score (DS) was 4.9 pre-RT versus 4.3 during RT (p = 0.01); Q DS was 4.3 pre-RT versus 4.0 during RT (p0.01). Improvements in V and Q functions were seen primarily in the ipsilateral lung (V DS, 1.9 pre-RT versus 1.4 during RT, p 0.01; Q DS, 1.7 pre-RT versus 1.5 during RT, p0.01). Baseline primary tumor volume was significantly correlated with pre-RT V/Q DS (p0.01). Patients with central lung tumors had greater interval changes in V and Q than those with more peripheral tumors (p0.05 for both V and Q DS).Regional ventilation and perfusion improved during RT at 45 Gy. This suggests that adaptive planning based on V/Q SPECT during RT may allow sparing of functionally recoverable lung tissue. |
Databáze: | OpenAIRE |
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