Geometric dose prediction model for hemithoracic intensity-modulated radiation therapy in mesothelioma patients with two intact lungs Journal Article


Authors: Kuo, L. C.; Yorke, E. D.; Dumane, V. A.; Foster, A.; Zhang, Z.; Mechalakos, J. G.; Wu, A. J.; Rosenzweig, K. E.; Rimner, A.
Article Title: Geometric dose prediction model for hemithoracic intensity-modulated radiation therapy in mesothelioma patients with two intact lungs
Abstract: The presence of two intact lungs makes it challenging to reach a tumoricidal dose with hemithoracic pleural intensity-modulated radiation therapy (IMRT) in patients with malignant pleural mesothelioma (MPM) who underwent pleurectomy/decortications or have unresectable disease. We developed an anatomy-based model to predict attainable prescription dose before starting optimization. Fifty-six clinically delivered IMRT plans were analyzed regarding correlation of prescription dose and individual and total lung volumes, planning target volume (PTV), ipsilateral normal lung volume and ratios: contralateral/ipsilateral lung (CIVR); contralateral lung/PTV (CPVR); ipsilateral lung /PTV (IPVR); ipsilateral normal lung /total lung (INTLVR); ipsilateral normal lung/PTV (INLPVR). Spearman's rank correlation and Fisher's exact test were used. Correlation between mean ipsilateral lung dose (MILD) and these volume ratios and between prescription dose and single lung mean doses were studied. The prediction models were validated in 23 subsequent MPM patients. CIVR showed the strongest correlation with dose (R = 0.603, p < 0.001) and accurately predicted prescription dose in the validation cases. INLPVR and MILD as well as MILD and prescription dose were significantly correlated (R = -0.784, p < 0.001 and R = 0.554, p < 0.001, respectively) in the training and validation cases. Parameters obtainable directly from planning scan anatomy predict achievable prescription doses for hemithoracic IMRT treatment of MPM patients with two intact lungs. © Creative Commons Attribution 4.0 International License.
Keywords: intensity-modulated radiation therapy (imrt); dose prediction model; malignant pleural mesothelioma (mpm)
Journal Title: Journal of Applied Clinical Medical Physics
Volume: 17
Issue: 3
ISSN: 1526-9914
Publisher: American College of Medical Physics  
Date Published: 2016-05-01
Start Page: 371
End Page: 379
Language: English
PROVIDER: scopus
PUBMED: 27167294
DOI: 10.1120/jacmp.v17i3.6199
PMCID: PMC5513486
DOI/URL:
Notes: Article -- Export Date: 1 July 2016 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Zhigang Zhang
    428 Zhang
  2. Li Cheng Kuo
    63 Kuo
  3. Andreas Rimner
    525 Rimner
  4. Abraham Jing-Ching Wu
    401 Wu
  5. Ellen D Yorke
    450 Yorke
  6. Amanda Foster
    64 Foster