The impact of emphysema on dosimetric parameters for stereotactic body radiotherapy of the lung

Satoru Ochiai, Yoshihito Nomoto, Yasufumi Yamashita, Tomoki Inoue, Shuuichi Murashima, Daisuke Hasegawa, Yoshie Kurita, Yui Watanabe, Yutaka Toyomasu, Tomoko Kawamura, Akinori Takada, Noriko, Shigeki Kobayashi, Hajime Sakuma

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

The purpose of this study was to evaluate the impact of emphysematous changes in lung on dosimetric parameters in stereotactic body radiation therapy (SBRT) for lung tumor. A total of 72 treatment plans were reviewed, and dosimetric factors [including homogeneity index (HI) and conformity index (CI)] were evaluated. Emphysematous changes in lung were observed in 43 patients (60%). Patients were divided into three groups according to the severity of emphysema: no emphysema (n = 29), mild emphysema (n = 22) and moderate to severe emphysema groups (n = 21). The HI (P < 0.001) and the CI (P = 0.029) were significantly different in accordance with the severity of emphysema in one-way analysis of variance (ANOVA). The HI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema (Tukey, P < 0.001) and mild emphysema groups (P = 0.002). The CI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema group (P = 0.044). In multiple linear regression analysis, the severity of emphysema (P < 0.001) and the mean material density of the lung within the PTV (P < 0.001) were significant factors for HI, and the mean density of the lung within the PTV (P = 0.005) was the only significant factor for CI. The mean density of the lung within the PTV was significantly different in accordance with the severity of emphysema (one-way ANOVA, P = 0.008) and the severity of emphysema (P < 0.001) was one of the significant factors for the density of the lung within the PTV in multiple linear regression analysis. Our results suggest that emphysematous changes in the lung significantly impact on several dosimetric parameters in SBRT, and they should be carefully evaluated before treatment planning.

Original languageEnglish
Pages (from-to)555-566
Number of pages12
JournalJournal of Radiation Research
Volume57
Issue number5
DOIs
Publication statusPublished - 01-09-2016

All Science Journal Classification (ASJC) codes

  • Radiation
  • Radiology Nuclear Medicine and imaging
  • Health, Toxicology and Mutagenesis

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