PET-based dose painting in non-small cell lung cancer: Comparing uniform dose escalation with boosting hypoxic and metabolically active sub-volumes. Issue 2 (August 2015)

• Record Type: Journal Article
• Authors: Even, Aniek J.G.; van der Stoep, Judith; Zegers, Catharina M.L.; Reymen, Bart; Troost, Esther G.C.; Lambin, Philippe; van Elmpt, Wouter
• Is Part Of: Radiotherapy and oncology. Volume 116:Issue 2(2015:Aug.)
• Page Start: 281
• Page End: 286
• Publication Date: 2015-08
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.07.013
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background and purpose</title> <p id="sp0005">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.</p> </sec> <sec> <title id="st015">Materials and methods</title> <p id="sp0010">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 (PTV<sub>prim</sub>); plan B, boosting sub-volume with FDG >50% SUV<sub>max</sub> (PTV<sub>FDG</sub>); plan C, boosting hypoxic volume with HX4 tumour-to-background >1.4 (PTV<sub>HX4</sub>).</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">Average boost volumes were 507 ± 466 cm<sup>3</sup> for PTV<sub>prim</sub>, 173 ± 127 cm<sup>3</sup> for PTV<sub>FDG</sub> and 114 ± 73 cm<sup>3</sup> for PTV<sub>HX4</sub>. The smaller PTV<sub>HX4</sub> overlapped on average 87 ± 16% with PTV<sub>FDG</sub>. Prescribed dose was escalated to 87 ± 10 Gy for PTV<sub>prim</sub>, 107 ± 20 Gy for PTV<sub>FDG</sub>, and 117 ± 15 Gy for PTV<sub>HX4</sub>, with comparable doses to the relevant organs-at-risk (OAR). Treatment plans are available online (<ext-link ext-link-type="unknown" id="ir1235" xlink:type="simple" xlink:href="https://www.cancerdata.org/10.1016/j.radonc.2015.07.013" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.cancerdata.org/10.1016/j.radonc.2015.07.013</ext-link>).</p> </sec> <sec> <title id="st025">Conclusions</title> <p id="sp0020">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 <italic>vice versa</italic>.</p> </sec> </abstract>