Advanced

Retrospective estimation of heart and lung doses in pediatric patients treated with spinal irradiation

Gasic, Daniel; Rosenschöld, Per Munck af LU ; Vogelius, Ivan R.; Maraldo, Maja V.; Aznar, Marianne C.; Nysom, Karsten; Björk-Eriksson, Thomas; Bentzen, Søren M. and Brodin, Nils Patrik (2018) In Radiotherapy and Oncology
Abstract

Background and purpose: The purpose of this study was to investigate whether treatment information from medical records can be used to estimate radiation doses to heart and lungs retrospectively in pediatric patients receiving spinal irradiation with conventional posterior fields. Material and methods: An algorithm for retrospective dosimetry in children treated with spinal irradiation was developed in a cohort of 21 pediatric patients with available CT-scans and treatment plans. We developed a multivariable linear regression model with explanatory variables identifiable in case note review for retrospective estimation of minimum, maximum, mean and V10%–V80% doses to the heart and lungs. Doses were estimated for... (More)

Background and purpose: The purpose of this study was to investigate whether treatment information from medical records can be used to estimate radiation doses to heart and lungs retrospectively in pediatric patients receiving spinal irradiation with conventional posterior fields. Material and methods: An algorithm for retrospective dosimetry in children treated with spinal irradiation was developed in a cohort of 21 pediatric patients with available CT-scans and treatment plans. We developed a multivariable linear regression model with explanatory variables identifiable in case note review for retrospective estimation of minimum, maximum, mean and V10%–V80% doses to the heart and lungs. Doses were estimated for both linear accelerator (Linac) and 60Co radiation therapy modalities. Results: Age and spinal field width were identified as statistically significant predictors of heart and lung doses in multivariable analyses (p < 0.01 in all models). Models showed excellent predictive performance with R2 = 0.70 for mean heart dose and 0.79 for mean lung dose, for Linac plans. In leave-one-out cross-validation analysis the average difference between predicted and actual mean heart dose was 6.7% and 7.6% of the prescription dose for Linac and 60Co plans, respectively, and 5.2% and 4.9% for mean lung dose. Due to the small sample size and large inter-patient variation in heart and lung dose, prospective studies validating these findings are highly warranted. Conclusions: The models presented here provide retrospective estimates of heart and lung doses for historical cohorts of pediatric patients, thus facilitating studies of long-term adverse effects of radiation.

(Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Dose estimation models, Heart and lungs, Linear regression models, Pediatric spinal irradiation, Retrospective dosimetry
in
Radiotherapy and Oncology
publisher
Elsevier
external identifiers
  • scopus:85047634899
ISSN
0167-8140
DOI
10.1016/j.radonc.2018.05.013
language
English
LU publication?
no
id
2edae543-21ae-4325-84d3-15676eeb9989
date added to LUP
2018-06-18 13:33:42
date last changed
2018-10-03 10:59:05
@article{2edae543-21ae-4325-84d3-15676eeb9989,
  abstract     = {<p>Background and purpose: The purpose of this study was to investigate whether treatment information from medical records can be used to estimate radiation doses to heart and lungs retrospectively in pediatric patients receiving spinal irradiation with conventional posterior fields. Material and methods: An algorithm for retrospective dosimetry in children treated with spinal irradiation was developed in a cohort of 21 pediatric patients with available CT-scans and treatment plans. We developed a multivariable linear regression model with explanatory variables identifiable in case note review for retrospective estimation of minimum, maximum, mean and V<sub>10%</sub>–V<sub>80%</sub> doses to the heart and lungs. Doses were estimated for both linear accelerator (Linac) and <sup>60</sup>Co radiation therapy modalities. Results: Age and spinal field width were identified as statistically significant predictors of heart and lung doses in multivariable analyses (p &lt; 0.01 in all models). Models showed excellent predictive performance with R<sup>2</sup> = 0.70 for mean heart dose and 0.79 for mean lung dose, for Linac plans. In leave-one-out cross-validation analysis the average difference between predicted and actual mean heart dose was 6.7% and 7.6% of the prescription dose for Linac and <sup>60</sup>Co plans, respectively, and 5.2% and 4.9% for mean lung dose. Due to the small sample size and large inter-patient variation in heart and lung dose, prospective studies validating these findings are highly warranted. Conclusions: The models presented here provide retrospective estimates of heart and lung doses for historical cohorts of pediatric patients, thus facilitating studies of long-term adverse effects of radiation.</p>},
  author       = {Gasic, Daniel and Rosenschöld, Per Munck af and Vogelius, Ivan R. and Maraldo, Maja V. and Aznar, Marianne C. and Nysom, Karsten and Björk-Eriksson, Thomas and Bentzen, Søren M. and Brodin, Nils Patrik},
  issn         = {0167-8140},
  keyword      = {Dose estimation models,Heart and lungs,Linear regression models,Pediatric spinal irradiation,Retrospective dosimetry},
  language     = {eng},
  month        = {01},
  publisher    = {Elsevier},
  series       = {Radiotherapy and Oncology},
  title        = {Retrospective estimation of heart and lung doses in pediatric patients treated with spinal irradiation},
  url          = {http://dx.doi.org/10.1016/j.radonc.2018.05.013},
  year         = {2018},
}