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e-Posters

18P - Precision radiotherapy for centrally located non-small cell lung cancer (NSCLC)

Date

06 Oct 2021

Session

e-Posters

Presenters

Eva Yi Wah Cheung

Citation

Annals of Oncology (2021) 32 (suppl_6): S1345-S1371. 10.1016/annonc/annonc740

Authors

E.Y.W. Cheung1, Y.C. Chan2, K.Y. Cheng2, Y.T. Cheng2, H.Y. Yung2

Author affiliations

  • 1 TWC-Tung Wah College:King's Park Campus, Kowloon/HK
  • 2 TWC-Tung Wah College:King's Park Campus, 852 - Kowloon/HK
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Abstract 18P

Background

Molecular analysis of lung tissue toxicity can be performed using radiotherapy dose volumetric parameters (DVP). Minimizing the percentage of volume of bilateral lung parenchyma (exclude tumor) receiving dose more than 20Gy (V20) and 5Gy (V5) and minimizing the mean lung dose (MLD) was proven to be effective to reduce the incidence of radiation induced pneumonitis (RP). We aimed at analyze the lung tissue toxicity between volumetric-modulated arc therapy (VMAT) with single-planar beam arrangement (SP-VMAT), and VMAT with dual-planar beam arrangement (DP-VMAT) based on DVP.

Methods

A retrospective study was conducted for 17 patients who were treated for stage III centrally located non-small cell lung cancer. Identical CT and structure data set were used to plan SP-VMAT, and DP-VMAT, with prescription to give 60Gy to PTV in 30 fractions. Radiotherapy thoracic DVP to planned target volume (PTV) (including Dmax, Dmean, Dmin, D98% (Gy), D95% (Gy), D50% (Gy), and D2% (Gy)) and DVP to both lungs excluding tumor (V20, V10, V5, and Dmean) were retrieved from SP-VMAT and DP-VMAT. Non parametric paired-T test were used for data analysis.

Results

There was no significant difference between all DVP to PTV in both SP-VMAT and DP-VMAT plans, suggesting both SP-VMAT and DP-VMAT plans were clinically acceptable. For DVP to both lungs (excluding tumor), the V5 of SP-VMAT (67.95% ± 14.65) was significantly lower than that of DP-VMAT 71.41 ± 11.83, p=0.006). For ipsilateral lung, Dmean, V10, V5 of SP-VMAT was 24.46Gy ± 5.55, 63.48% ± 14.88 and 71.98% ± 16.18 respectively, which were significantly lower than that of DP-VMAT 25.63Gy ± 5.03, 69.8%±11.73 and 79.73%±11.8.

Conclusions

The SP-VMAT in this study showed more favorable DVP in both lungs and ipsilateral lung for centrally located NSCLC. The features of dose distribution can be applied in precision medicine in oncology.

Legal entity responsible for the study

Tung Wah College, Hong Kong.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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