Alpha Beta Ratio For Lung
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The document summarizes a study estimating the alpha/beta ratio for radiation-induced lung injury based on SPECT lung perfusion imaging of patients before and after radiotherapy. Regions of lung receiving different fractional doses were identified for 32 patients based on their treatment plans. The reduction in regional lung perfusion was quantified and correlated with dose to calculate an alpha/beta ratio of 1.6 to 3.1 Gy, indicating lung is an early-responding tissue. Doses as low as 0.35 Gy per fraction were found to reduce regional lung function, which may be clinically important with advanced planning techniques.
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![Estimation of the alpha / beta ratio for lung injury based on direct measurements of radiotherapy (RT)-induced reductions in regional perfusion in human patients Bridget Koontz, Su-min Zhou, Elizabeth Evans, Zeljko Vujaskovic, Ron Jazczack, Terence Wong, and Lawrence Marks Department of Radiation Oncology, Duke University Medical Center, Durham, NC USA ,[object Object],[object Object],[object Object],[object Object],1/ED50 VERSUS FRACTION SIZE: Effect α D (a + bd) 1/D α a + bd y-intercept = alpha slope = beta 100 evaluable lung cancer patients with pre and post RT SPECTs ,[object Object],[object Object],[object Object],32 patients selected for unique beam arrangement, dose/fx, total dose 2 QD 12 pts 24 beams 1.8 QD 2 pts 3 beams Supported by NIH Grant CA069579 Acknowledgement ro UNC-CH for use of PLUNC 35 cGy/fx 160 cGy/fx 125 cGy/fx Pre-RT Post-RT Quantify perfusion loss for each dose regimen Alpha/beta ≈ 1.6-3.1 Based on the beam arrangement used, areas of lung receiving specific doses per fraction were identified (Gy) 1.6 QD 1 pt 1 beam 1.6 BID 10 pts 10 beams 1.25 BID 4 pts 4 beams 0.35 BID 4 pt s 4 beams Data fit using 3 models ED50 = 62 Gy ED50 = 52 Gy ED50 = 19 Gy ED50 = 42 Gy ED50 = 34 Gy Total Dose (Gy) Total Dose (Gy) Total Dose (Gy) Total Dose (Gy) ED50 = 50 Gy Total Dose (Gy) Total Dose (Gy) Using % perfusion reduction at maximum population volume, estimated dose causing 50% perfusion reduction](https://image.slidesharecdn.com/alphabetaratioforlung-090306154105-phpapp01/85/Alpha-Beta-Ratio-For-Lung-1-320.jpg)
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The purpose of this study was to investigate the target dose discrepancy caused by intrafraction variation during Stereotactic Body Radiotherapy (SBRT) for lung cancer. Intensity-Modulated Radiation Therapy (IMRT) plans were designed based on Average Computed Tomography (AVG CT) utilizing the Planning Target Volume (PTV) surrounding the 65% and 85% prescription isodoses in both phantom and patient cases. Intrafraction variation was simulated by shifting the nominal plan isocenter along six directions from 0.5 mm to 4.5 mm with a 1-mm step size to produce a series of perturbed plans. The dose discrepancy between the initial plan and the perturbed plans was calculated as the percentage of the initial plan. Dose indices, including D99 and D95 for Internal Target Volume (ITV) and Gross Tumor Volume (GTV), were adopted as endpoint samples. The mean dose discrepancy was calculated under the 3-dimensional space distribution. In this study, we found that intrafraction motion can lead to serious dose degradation of the target and ITV in lung SBRT, especially during SBRT with PTV surrounding the lower isodose line. This phenomenon was compromised when 3-dimensional space distribution was considered. This result may provide a prospective reference for target dose degradation due to intrafraction motion during lung SBRT treatment.
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MCO 2011 - Slide 28 - C. Faivre-Finn - SCLC
- Small cell lung cancer (SCLC) has seen little therapeutic advancement in over 20 years. Platinum-etoposide remains the standard chemotherapy regimen.
- For limited-stage SCLC, concurrent chemoradiation is the standard of care and provides better outcomes than sequential treatment. Early twice-daily radiotherapy with prophylactic cranial irradiation improves survival.
- For extensive-stage SCLC, prophylactic cranial irradiation after chemotherapy reduces the risk of brain metastases and improves survival compared to no cranial irradiation.
MON 2011 - Slide 25 - C. Faivre-Finn - SCLC
The document discusses small cell lung cancer (SCLC) treatment. It covers:
1) Chemotherapy with platinum-etoposide is the standard first-line treatment, though newer agents show promise.
2) For limited-stage SCLC, concurrent chemoradiation is the standard of care and improves survival compared to sequential treatment.
3) For extensive-stage SCLC, prophylactic cranial irradiation reduces the risk of brain metastases and improves survival when given with chemotherapy.
Topic -Analysis of Patients specific Quality Assurance of IMRT/VMAT
Analysis and How to process of doing Pre-treatment Quality assurance of VMAT Plans. Here I described only Point Dose.
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SBRT/SABR for Early Stage Lung Cancer: A Brief Overview
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CT radiation dose concepts and radiation dose optimization- Avinesh Shrestha
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Optimizar la protección radiológica del paciente o inferir riesgos de radiaci...
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Dosimetric Consequences of Intrafraction Variation of Tumor Motion in Lung St...
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Dosimetric Consequences of Intrafraction Variation of Tumor Motion in Lung St...
Dosimetric Consequences of Intrafraction Variation of Tumor Motion in Lung St...
Dosimetric Consequences of Intrafraction Variation of Tumor Motion in Lung St...
Dosimetric Consequences of Intrafraction Variation of Tumor Motion in Lung St...
Topic -Analysis of Patients specific Quality Assurance of IMRT/VMAT
Topic -Analysis of Patients specific Quality Assurance of IMRT/VMAT
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