Advanced

NTCP modelling and pulmonary function tests evaluation for the prediction of radiation induced pneumonitis in non-small-cell lung cancer radiotherapy

Tsougos, Ioannis; Nilsson, Per LU ; Theodorou, Kiki; Kjellén, Elisabeth LU ; Ewers, Sven-Börje LU ; Jarlman, Olof LU ; Lind, Bengt K.; Kappas, Constantin and Mavroidis, Panayiotis (2007) In Physics in Medicine and Biology 52(4). p.1055-1073
Abstract
This work aims to evaluate the predictive strength of the relative seriality, parallel and Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) models regarding the incidence of radiation pneumonitis (RP), in a group of patients following lung cancer radiotherapy and also to examine their correlation with pulmonary function tests (PFTs). The study was based on 47 patients who received radiation therapy for stage III non-small-cell lung cancer. For each patient, lung dose volume histograms (DVHs) and the clinical treatment outcome were available. Clinical symptoms, radiological findings and pulmonary function tests incorporated in a post-treatment follow-up period of 18 months were used to assess the manifestation of... (More)
This work aims to evaluate the predictive strength of the relative seriality, parallel and Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) models regarding the incidence of radiation pneumonitis (RP), in a group of patients following lung cancer radiotherapy and also to examine their correlation with pulmonary function tests (PFTs). The study was based on 47 patients who received radiation therapy for stage III non-small-cell lung cancer. For each patient, lung dose volume histograms (DVHs) and the clinical treatment outcome were available. Clinical symptoms, radiological findings and pulmonary function tests incorporated in a post-treatment follow-up period of 18 months were used to assess the manifestation of radiation induced complications. Thirteen of the 47 patients were scored as having radiation induced pneumonitis, with RTOG criteria grade >= 3 and 28 of the 47 with RTOG criteria grade >= 2. Using this material, different methods of estimating the likelihood of radiation effects were evaluated, by analysing patient data based on their full dose distributions and associating the calculated complication rates with the clinical follow-up records. Lungs were evaluated as a paired organ as well as individual lungs. Of the NTCP models examined in the overall group considering the dose distribution in the ipsilateral lung, all models were able to predict radiation induced pneumonitis only in the case of grade 2 radiation pneumonitis score, with the LKB model giving the best results (chi(2)-test: probability of agreement between the observed and predicted results P chi(chi(2))= 0.524 using the 0.05 significance level). The NTCP modelling considering lungs as a paired organ did not give statistically acceptable results. In the case of lung cancer radiotherapy, the application of different published radiobiological parameters alters the NTCP results, but not excessively as in the case of breast cancer radiotherapy. In this relatively small group of lung cancer patients, no positive statistical correlation could be established between the incidence of radiation pneumonitis as estimated by NTCP models and the pulmonary function test evaluation. However, the use of PFTs as markers or predictors for the incidence or severity of radiation induced pneumonitis must be investigated further. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Physics in Medicine and Biology
volume
52
issue
4
pages
1055 - 1073
publisher
IOP Publishing
external identifiers
  • wos:000244714100013
  • scopus:34247150396
ISSN
1361-6560
DOI
10.1088/0031-9155/52/4/013
language
English
LU publication?
yes
id
c7daee4a-a816-4c54-9218-ec2606a46b76 (old id 670964)
date added to LUP
2008-01-03 11:21:16
date last changed
2017-05-28 03:41:41
@article{c7daee4a-a816-4c54-9218-ec2606a46b76,
  abstract     = {This work aims to evaluate the predictive strength of the relative seriality, parallel and Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) models regarding the incidence of radiation pneumonitis (RP), in a group of patients following lung cancer radiotherapy and also to examine their correlation with pulmonary function tests (PFTs). The study was based on 47 patients who received radiation therapy for stage III non-small-cell lung cancer. For each patient, lung dose volume histograms (DVHs) and the clinical treatment outcome were available. Clinical symptoms, radiological findings and pulmonary function tests incorporated in a post-treatment follow-up period of 18 months were used to assess the manifestation of radiation induced complications. Thirteen of the 47 patients were scored as having radiation induced pneumonitis, with RTOG criteria grade >= 3 and 28 of the 47 with RTOG criteria grade >= 2. Using this material, different methods of estimating the likelihood of radiation effects were evaluated, by analysing patient data based on their full dose distributions and associating the calculated complication rates with the clinical follow-up records. Lungs were evaluated as a paired organ as well as individual lungs. Of the NTCP models examined in the overall group considering the dose distribution in the ipsilateral lung, all models were able to predict radiation induced pneumonitis only in the case of grade 2 radiation pneumonitis score, with the LKB model giving the best results (chi(2)-test: probability of agreement between the observed and predicted results P chi(chi(2))= 0.524 using the 0.05 significance level). The NTCP modelling considering lungs as a paired organ did not give statistically acceptable results. In the case of lung cancer radiotherapy, the application of different published radiobiological parameters alters the NTCP results, but not excessively as in the case of breast cancer radiotherapy. In this relatively small group of lung cancer patients, no positive statistical correlation could be established between the incidence of radiation pneumonitis as estimated by NTCP models and the pulmonary function test evaluation. However, the use of PFTs as markers or predictors for the incidence or severity of radiation induced pneumonitis must be investigated further.},
  author       = {Tsougos, Ioannis and Nilsson, Per and Theodorou, Kiki and Kjellén, Elisabeth and Ewers, Sven-Börje and Jarlman, Olof and Lind, Bengt K. and Kappas, Constantin and Mavroidis, Panayiotis},
  issn         = {1361-6560},
  language     = {eng},
  number       = {4},
  pages        = {1055--1073},
  publisher    = {IOP Publishing},
  series       = {Physics in Medicine and Biology},
  title        = {NTCP modelling and pulmonary function tests evaluation for the prediction of radiation induced pneumonitis in non-small-cell lung cancer radiotherapy},
  url          = {http://dx.doi.org/10.1088/0031-9155/52/4/013},
  volume       = {52},
  year         = {2007},
}