PET-based dose painting in non-small cell lung cancer: Comparing uniform dose escalation with boosting hypoxic and metabolically active sub-volumes

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Aniek J.G. Even - , Maastricht University (Autor:in)
  • Judith Van Der Stoep - , Maastricht University (Autor:in)
  • Catharina M.L. Zegers - , Maastricht University (Autor:in)
  • Bart Reymen - , Maastricht University (Autor:in)
  • Esther G.C. Troost - , Maastricht University, Helmholtz-Zentrum Dresden-Rossendorf (Autor:in)
  • Philippe Lambin - , Maastricht University (Autor:in)
  • Wouter Van Elmpt - , Maastricht University (Autor:in)

Abstract

Background and purpose We compared two imaging biomarkers for dose-escalation in patients with advanced non-small cell lung cancer (NSCLC). Treatment plans boosting metabolically active sub-volumes defined by FDG-PET or hypoxic sub-volumes defined by HX4-PET were compared with boosting the entire tumour. Materials and methods Ten NSCLC patients underwent FDG- and HX4-PET/CT scans prior to radiotherapy. Three isotoxic dose-escalation plans were compared per patient: plan A, boosting the primary tumour (PTVprim); plan B, boosting sub-volume with FDG >50% SUVmax (PTVFDG); plan C, boosting hypoxic volume with HX4 tumour-to-background >1.4 (PTVHX4). Results Average boost volumes were 507 ± 466 cm3 for PTVprim, 173 ± 127 cm3 for PTVFDG and 114 ± 73 cm3 for PTVHX4. The smaller PTVHX4 overlapped on average 87 ± 16% with PTVFDG. Prescribed dose was escalated to 87 ± 10 Gy for PTVprim, 107 ± 20 Gy for PTVFDG, and 117 ± 15 Gy for PTVHX4, with comparable doses to the relevant organs-at-risk (OAR). Treatment plans are available online (https://www.cancerdata.org/10.1016/j.radonc.2015.07.013). Conclusions Dose escalation based on metabolic sub-volumes, hypoxic sub-volumes and the entire tumour is feasible. Highest dose was achieved for hypoxia plans, without increasing dose to OAR. For most patients, boosting the metabolic sub-volume also resulted in boosting the hypoxic volume, although to a lower dose, but not vice versa.

Details

OriginalspracheEnglisch
Seiten (von - bis)281-286
Seitenumfang6
FachzeitschriftRadiotherapy and oncology
Jahrgang116
Ausgabenummer2
PublikationsstatusVeröffentlicht - 2015
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

PubMed 26238010

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Dose painting, FDG, HX4, NSCLC, Positron emission tomography, Radiotherapy