[¹⁸F]fluorodeoxyglucose uptake patterns in lung before radiotherapy identify areas more susceptible to radiation-induced lung toxicity in non-small-cell lung cancer patients
| Autor: | Petit, Steven F, van Elmpt, Wouter J C, Oberije, Cary J G, Vegt, Erik, Dingemans, Anne-Marie C, Lambin, Philippe, Dekker, André L A J, De Ruysscher, Dirk |
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| Přispěvatelé: | Radiotherapie, Beeldvorming, MUMC+: DA BV Medische staf (6), Pulmonologie, RS: GROW - School for Oncology and Reproduction |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Aged 80 and over Male Lung Neoplasms Research Support Non-U.S. Gov't Age Factors Chemoradiotherapy Middle Aged Multimodal Imaging Radiation Pneumonitis Dyspnea Logistic Models Fluorodeoxyglucose F18 Carcinoma Non-Small-Cell Lung Positron-Emission Tomography Odds Ratio Journal Article Humans Female Radiopharmaceuticals Tomography X-Ray Computed Lung Aged Retrospective Studies |
| Zdroj: | International Journal of Radiation Oncology Biology Physics, 81(3), 698-705. Elsevier Science |
| ISSN: | 0360-3016 |
| Popis: | PURPOSE: Our hypothesis was that pretreatment inflammation in the lung makes pulmonary tissue more susceptible to radiation damage. The relationship between pretreatment [(18)F]fluorodeoxyglucose ([(18)F]FDG) uptake in the lungs (as a surrogate for inflammation) and the delivered radiation dose and radiation-induced lung toxicity (RILT) was investigated. METHODS AND MATERIALS: We retrospectively studied a prospectively obtained cohort of 101 non-small-cell lung cancer patients treated with (chemo)radiation therapy (RT). [(18)F]FDG-positron emission tomography-computed tomography (PET-CT) scans used for treatment planning were studied. Different parameters were used to describe [(18)F]FDG uptake patterns in the lungs, excluding clinical target volumes, and the interaction with radiation dose. An increase in the dyspnea grade of 1 (Common Terminology Criteria for Adverse Events version 3.0) or more points compared to the pre-RT score was used as an endpoint for analysis of RILT. The effect of [(18)F]FDG and CT-based variables, dose, and other patient or treatment characteristics that effected RILT was studied using logistic regression. RESULTS: Increased lung density and pretreatment [(18)F]FDG uptake were related to RILT after RT with univariable logistic regression. The 95th percentile of the [(18)F]FDG uptake in the lungs remained significant in multivariable logistic regression (p = 0.016; odds ratio [OR] = 4.3), together with age (p = 0.029; OR = 1.06), and a pre-RT dyspnea score of ≥1 (p = 0.005; OR = 0.20). Significant interaction effects were demonstrated among the 80th, 90th, and 95th percentiles and the relative lung volume receiving more than 2 and 5 Gy. CONCLUSIONS: The risk of RILT increased with the 95th percentile of the [(18)F]FDG uptake in the lungs, excluding clinical tumor volume (OR = 4.3). The effect became more pronounced as the fraction of the 5%, 10%, and 20% highest standardized uptake value voxels that received more than 2 Gy to 5 Gy increased. Therefore, the risk of RILT may be decreased by applying sophisticated radiotherapy techniques to avoid areas in the lung with high [(18)F]FDG uptake. |
| Databáze: | OpenAIRE |
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