ESTRO 2024 - Abstract Book

S1584

Clinical - Lung

ESTRO 2024

ln(PTV)

0.01

1.29

0.18

1.17

<0.0001

1.63

0.001

1.61

PS ≥ 2

0.03

1.26

0.03

1.41

0.02

1.54

0.02

1.54

Male

0.49

1.10

-

-

0.59

1.11

-

-

MLD

0.04

1.04

0.29

1.02

<0.001

1.10

0.35

1.03

fMLD CTVI-Jac †

0.20

1.01

-

-

0.09

1.03

-

-

fMLD CTVI-HU †

0.15

1.01

-

-

0.03

1.03

-

-

fMLD CTVI-Jac *

0.13

1.05

-

-

<0.01

1.14

-

-

fMLD CTVI-HU *

0.12

1.05

-

-

<0.01

1.14

-

-

Table 1. Results of univariate and multivariate analyses for survival. †: structure -based approach with 85th percentile cut-off. *: voxel-based approach with dose weighted by ventilation percentile.

Conclusion:

To our knowledge, this is the first study that correlates lung dose and 4DCT ventilation-based function with survival after radiation therapy. Based on concordance-index values, dose-function metrics do not better predict survival compared to dose-volume metrics in this cohort of SABR and non-SABR patients. We hypothesise that the poor performance of functional metrics is related to 4DCT artefacts. This finding may impact on future trial designs.

Keywords: 4DCT, lung radiotherapy, pulmonary ventilation

References:

1. Faught AM, Miyasaka Y, Kadoya N, Castillo R, Castillo E, Vinogradskiy Y, Yamamoto T. Evaluating the toxicity reduction with computed tomographic ventilation functional avoidance radiation therapy. Int J Radiat Oncol Biol Phys. 2017;99(2):325-333. 2. Vinogradskiy Y, Castillo R, Castillo E, Tucker SL, Liao Z, Guerrero T, Martel MK. Use of 4-dimensional computed tomography-based ventilation imaging to correlate lung dose and function with clinical outcomes. Int J Radiat Oncol Biol Phys. 2013;86(2):366-371. 3. Dupic G, Biau J, Molnar I, Chassin V, Dedieu V, Lapeyre M, Bellière-Calandry A. Significant Correlation Between Overall Survival and Mean Lung Dose in Lung Stereotactic Body Radiation Therapy (SBRT). Frontiers in Oncology, vol. 10, 2020 4. Kipritidis J, Woodruff HC, Eslick EM, Hegi-Johnson F, Keall PJ. New pathways for end-to-end validation of CT ventilation imaging (CTVI) using deformable image registration. Proceedings - International Symposium on Biomedical Imaging, vol. 2016-June, IEEE Computer Society, Jun. 2016, pp. 939 – 942