PET-based dose painting in non-small cell lung cancer: Comparing uniform dose escalation with boosting hypoxic and metabolically active sub-volumes
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
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
Original language | English |
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Pages (from-to) | 281-286 |
Number of pages | 6 |
Journal | Radiotherapy and oncology |
Volume | 116 |
Issue number | 2 |
Publication status | Published - 2015 |
Peer-reviewed | Yes |
Externally published | Yes |
External IDs
PubMed | 26238010 |
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Keywords
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Dose painting, FDG, HX4, NSCLC, Positron emission tomography, Radiotherapy