TY - JOUR
T1 - Three-dimensional conformal radiation may deliver considerable dose of incidental nodal irradiation in patients with early stage node-negative non-small cell lung cancer when the tumor is large and centrally located
AU - Zhao, Lujun
AU - Chen, Ming
AU - Ten Haken, Randall
AU - Chetty, Indrin
AU - Chapet, Olivier
AU - Hayman, James A.
AU - Kong, Feng Ming
PY - 2007/2
Y1 - 2007/2
N2 - Background and purpose: To determine the dose to regional nodal stations in patients with T1-3N0M0 non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT) without intentional elective nodal irradiation (ENI). Materials and methods: Twenty-three patients with medically inoperable T1-3N0M0 NSCLC were treated with 3DCRT without ENI. Hilar and mediastinal nodal regions were contoured on planning CT. The prescription dose was normalized to 70 Gy. Equivalent uniform dose (EUD) and other dosimetric parameters (e.g., V40) were calculated for each nodal station. Results: The median EUD for the whole group ranged from 0.4 to 4.4 Gy for all elective nodal regions. Gross tumor volume (GTV) and the relationship between GTV and hilum were significantly correlated with irradiation dose to ipsilateral hilar nodal regions (P < .05). For patients with GTV ≥ 30.2 cm3 (diameter ≈ 4 cm) and or having any overlap with hilum, the median EUDs were 9.6, 22.6, and 62.9 Gy for ipsilateral lower paratracheal, subcarinal, and ipsilateral hilar regions, respectively. The corresponding median V40 were 32.5%, 39.3%, and 97.6%, respectively. Conclusions: Although incidental nodal irradiation dose is low in the whole group, the dose to high-risk nodal regions is considerable in patients with T1-3N0 NSCLC when the primary is large and/or centrally located.
AB - Background and purpose: To determine the dose to regional nodal stations in patients with T1-3N0M0 non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT) without intentional elective nodal irradiation (ENI). Materials and methods: Twenty-three patients with medically inoperable T1-3N0M0 NSCLC were treated with 3DCRT without ENI. Hilar and mediastinal nodal regions were contoured on planning CT. The prescription dose was normalized to 70 Gy. Equivalent uniform dose (EUD) and other dosimetric parameters (e.g., V40) were calculated for each nodal station. Results: The median EUD for the whole group ranged from 0.4 to 4.4 Gy for all elective nodal regions. Gross tumor volume (GTV) and the relationship between GTV and hilum were significantly correlated with irradiation dose to ipsilateral hilar nodal regions (P < .05). For patients with GTV ≥ 30.2 cm3 (diameter ≈ 4 cm) and or having any overlap with hilum, the median EUDs were 9.6, 22.6, and 62.9 Gy for ipsilateral lower paratracheal, subcarinal, and ipsilateral hilar regions, respectively. The corresponding median V40 were 32.5%, 39.3%, and 97.6%, respectively. Conclusions: Although incidental nodal irradiation dose is low in the whole group, the dose to high-risk nodal regions is considerable in patients with T1-3N0 NSCLC when the primary is large and/or centrally located.
KW - 3D conformal radiation therapy
KW - Dismetric analysis
KW - Incidental nodal irradiation
KW - NSCLC
KW - Node-negative disease
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U2 - 10.1016/j.radonc.2007.01.006
DO - 10.1016/j.radonc.2007.01.006
M3 - Article
C2 - 17287040
AN - SCOPUS:33847044802
SN - 0167-8140
VL - 82
SP - 153
EP - 159
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -