Retrospective Cohort Study of Bronchial Doses and Radiation-Induced Atelectasis After Stereotactic Body Radiation Therapy of Lung Tumors Located Close to the Bronchial Tree

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• 作者：Kristin Karlsson ; Jan Nyman ; Pia Baumann ; Peter Wers?ll ; Ninni Drugge ; Giovanna Gagliardi ; Karl-Axel Johansson ; Jan-Olov Persson ; Eva Rutkowska ; Owe Tullgren ; Ingmar Lax
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2013
• 出版时间：1 November, 2013
• 年：2013
• 卷：87
• 期：3
• 页码：590-595
• 全文大小：832 K

文摘

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Purpose

To evaluate the dose-response relationship between radiation-induced atelectasis after stereotactic body radiation therapy (SBRT) and bronchial dose.

Methods and Materials

Seventy-four patients treated with SBRT for tumors close to main, lobar, or segmental bronchi were selected. The association between incidence of atelectasis and bronchial dose parameters (maximum point-dose and minimum dose to the high-dose bronchial volume [ranging from 0.1 cm³ up to 2.0 cm³]) was statistically evaluated with survival analysis models.

Results

Prescribed doses varied between 4 and 20 Gy per fraction in 2-5 fractions. Eighteen patients (24.3 % ) developed atelectasis considered to be radiation-induced. Statistical analysis showed a significant correlation between the incidence of radiation-induced atelectasis and minimum dose to the high-dose bronchial volumes, of which 0.1 cm³ (D_0.1cm3) was used for further analysis. The median value of D_0.1cm3 (¦Á/¦Â = 3 Gy) was EQD_2,LQ = 147 Gy₃ (range, 20-293 Gy₃). For patients who developed atelectasis the median value was EQD_2,LQ = 210 Gy₃, and for patients who did not develop atelectasis, EQD_2,LQ = 105 Gy₃. Median time from treatment to development of atelectasis was 8.0 months (range, 1.1-30.1 months).

Conclusion

In this retrospective study a significant dose-response relationship between the incidence of atelectasis and the dose to the high-dose volume of the bronchi is shown.