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Radiographic changes in lung of patients treated with stereotactic ablative body radiation therapy: low-dose volumes as the driving force for radiographic change

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

To describe radiographic evidence of radiation pneumonitis (rRP) and fibrosis (rRF) and determine what dosimetric parameters correlate with rRP and rRF after stereotactic ablative radiation therapy (SABR) to the lung.

Methods

Ninety-eight follow-up computed tomography (CT) scans from 32 patients treated by SABR were retrospectively reviewed for CT appearance of rRP and rRF determined by the Ikezoe (≤6 months) and Koenig (≥7 months) systems. The dosimetric correlations for rRP, rRF, and fibrotic volume were analyzed.

Results

There was a 55 % incidence of rRP and 59 % incidence of rRF with a median follow-up of 10 months. Only the low-dose parameters V 2.5, V 5, V 7, and V 10 (the volume of lung receiving more than 2.5, 5, 7, and 10 Gy of radiation, respectively) were correlated to the development of rRP (p < 0.05). No parameter correlated with rRF, but V 5, V 7, and V 10 trended toward significance. The absolute fibrotic volume was correlated with the planning target volume (p = 0.01) and V 7 (p = 0.02).

Conclusion

The development of rRP and the fibrotic volume after SABR was correlated with the volume of lung that received lower doses of radiation.

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Authors and Affiliations

  1. Department of Radiation Oncology, Kansas City VA Medical Center, 10500 Mastin St., Overland Park, KS, 66212, USA

    John Park

  2. Department of Radiology, University of Missouri, 2411 Holmes St., Kansas City, MO, 64108,, USA

    John Park

  3. Department of Radiation Oncology, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4033, Kansas City, KS, 66160,, USA

    Saikat Das, Bruce F. Kimler, Rajeev Badkul, Parvesh Kumar & Fen Wang

  4. Department of Radiation Oncology, Ohio State University, 300 W. 10th Avenue Columbus, Columbus, OH, 43210,, USA

    Nicole Nolan

  5. Departments of Radiology and Health Policy and Management, University of Kansas Medical Center, 3901 Rainbow Blvd. MS 4032, Kansas City, KS, 66160,, USA

    Glendon Cox

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Correspondence to John Park.

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Funding

There were no sources of funding for this project.

Conflict of interest statements

John Park does not have any conflict of interests to report.

Saikat Das does not have any conflict of interests to report.

Bruce F. Kimler does not have any conflict of interests to report.

Rajeev Badkul does not have any conflict of interests to report.

Nicole Nolan does not have any conflict of interests to report.

Parvesh Kumar does not have any conflict of interests to report.

Glendon Cox does not have any conflict of interests to report.

Fen Wang does not have any conflict of interests to report.

Ethical standards

This article does not contain any studies with human or animal subjects performed by any of the authors. All patient information was collected on an Institutional Review Board and Human Subjects Committee approved study.

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Park, J., Das, S., Kimler, B.F. et al. Radiographic changes in lung of patients treated with stereotactic ablative body radiation therapy: low-dose volumes as the driving force for radiographic change. J Radiat Oncol 5, 265–272 (2016). https://doi.org/10.1007/s13566-016-0254-7

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  • DOI: https://doi.org/10.1007/s13566-016-0254-7

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