Impact of Fraction Size on Lung Radiation Toxicity

Hypofractionation may be Beneficial in Dose Escalation of Radiotherapy for Lung Cancers

JianYue Jin, Feng Ming Kong, Indrin J. Chetty, Munther Ajlouni, Samuel Ryu, Randall Ten Haken, Benjamin Movsas

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: To assess how fraction size impacts lung radiation toxicity and therapeutic ratio in treatment of lung cancers. Methods and Materials: The relative damaged volume (RDV) of lung was used as the endpoint in the comparison of various fractionation schemes with the same normalized total dose (NTD) to the tumor. The RDV was computed from the biologically corrected lung dose-volume histogram (DVH), with an α/β ratio of 3 and 10 for lung and tumor, respectively. Two different (linear and S-shaped) local dose-effect models that incorporated the concept of a threshold dose effect with a single parameter DL50 (dose at 50% local dose effect) were used to convert the DVH into the RDV. The comparison was conducted using four representative DVHs at different NTD and DL50 values. Results: The RDV decreased with increasing dose/fraction when the NTD was larger than a critical dose (DCR) and increased when the NTD was less than DCR. The DCR was 32-50 Gy and 58-87 Gy for a small tumor (11 cm3) for the linear and S-shaped local dose-effect models, respectively, when DL50 was 20-30 Gy. The DCR was 66-97 Gy and 66-99 Gy, respectively, for a large tumor (266 cm3). Hypofractionation was preferred for small tumors and higher NTDs, and conventional fractionation was better for large tumors and lower NTDs. Hypofractionation might be beneficial for intermediate-sized tumors when NTD = 80-90 Gy, especially if the DL50 is small (20 Gy). Conclusion: This computational study demonstrated that hypofractionated stereotactic body radiotherapy is a better regimen than conventional fractionation in lung cancer patients with small tumors and high doses, because it generates lower RDV when the tumor NTD is kept unchanged.

Original languageEnglish (US)
Pages (from-to)782-788
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume76
Issue number3
DOIs
StatePublished - Mar 1 2010

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toxicity
lungs
radiation therapy
Lung Neoplasms
Radiotherapy
cancer
Radiation
dosage
Lung
radiation
tumors
Neoplasms
fractionation
Radiosurgery
Tumor Burden
histograms
Therapeutics

Keywords

  • Hypofraction
  • Non-small-cell lung cancer
  • Normal tissue complication probability
  • Radiobiology
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Impact of Fraction Size on Lung Radiation Toxicity : Hypofractionation may be Beneficial in Dose Escalation of Radiotherapy for Lung Cancers. / Jin, JianYue; Kong, Feng Ming; Chetty, Indrin J.; Ajlouni, Munther; Ryu, Samuel; Ten Haken, Randall; Movsas, Benjamin.

In: International Journal of Radiation Oncology Biology Physics, Vol. 76, No. 3, 01.03.2010, p. 782-788.

Research output: Contribution to journalArticle

Jin, JianYue ; Kong, Feng Ming ; Chetty, Indrin J. ; Ajlouni, Munther ; Ryu, Samuel ; Ten Haken, Randall ; Movsas, Benjamin. / Impact of Fraction Size on Lung Radiation Toxicity : Hypofractionation may be Beneficial in Dose Escalation of Radiotherapy for Lung Cancers. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 76, No. 3. pp. 782-788.
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T2 - Hypofractionation may be Beneficial in Dose Escalation of Radiotherapy for Lung Cancers

AU - Jin, JianYue

AU - Kong, Feng Ming

AU - Chetty, Indrin J.

AU - Ajlouni, Munther

AU - Ryu, Samuel

AU - Ten Haken, Randall

AU - Movsas, Benjamin

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KW - Normal tissue complication probability

KW - Radiobiology

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