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Article: Dosimetric analysis of brachial plexopathy after stereotactic body radiotherapy: Significance of organ delineation

TitleDosimetric analysis of brachial plexopathy after stereotactic body radiotherapy: Significance of organ delineation
Authors
KeywordsBrachial plexopathy
Delineation
Dosimetric analysis
Stereotactic body radiotherapy
Issue Date1-Jan-2024
PublisherElsevier
Citation
Radiotherapy & Oncology, 2024, v. 190 How to Cite?
Abstract

Objectives

Examine the significance of contouring the brachial plexus (BP) for toxicity estimation and select metrics for predicting radiation-induced brachial plexopathy (RIBP) after stereotactic body radiotherapy.

Materials and Methods

Patients with planning target volume (PTV) ≤ 2 cm from the BP were eligible. The BP was contoured primarily according to the RTOG 1106 atlas, while subclavian-axillary veins (SAV) were contoured according to RTOG 0236. Apical PTVs were classified as anterior (PTV-A) or posterior (PTV-B) PTVs. Variables predicting grade 2 or higher RIBP (RIBP2) were selected through least absolute shrinkage and selection operator regression and logistic regression.

Results

Among 137 patients with 140 BPs (median follow-up, 32.1 months), 11 experienced RIBP2. For patients with RIBP2, the maximum physical dose to the BP (BP-Dmax) was 46.5 Gy (median; range, 35.7 to 60.7 Gy). Of these patients, 54.5 % (6/11) satisfied the RTOG limits when using SAV delineation; among them, 83.3 % (5/6) had PTV-B. For patients with PTV-B, the maximum physical dose to SAV (SAV-Dmax) was 11.2 Gy (median) lower than BP-Dmax. Maximum and 0.3 cc biologically effective doses to the BP based on the linear-quadratic-linear model (BP-BEDmax LQL and BP-BED0.3cc LQL, α/β = 3) were selected as predictive variables with thresholds of 118 and 73 Gy, respectively.

Conclusion

Contouring SAV may significantly underestimate the RIBP2 risk in dosimetry, especially for patients with PTV-B. BP contouring indicated BP-BED0.3cc LQL and BP-BEDmax LQL as potential predictors of RIBP2.


Persistent Identifierhttp://hdl.handle.net/10722/343934
ISSN
2023 Impact Factor: 4.9
2023 SCImago Journal Rankings: 1.702

 

DC FieldValueLanguage
dc.contributor.authorNiu, Geng-Min-
dc.contributor.authorGao, Miao-Miao-
dc.contributor.authorWang, Xiao-Feng-
dc.contributor.authorDong, Yang-
dc.contributor.authorZhang, Yi-Fan-
dc.contributor.authorWang, Huan-Huan-
dc.contributor.authorGuan, Yong-
dc.contributor.authorCheng, Ze-Yuan-
dc.contributor.authorZhao, Shu-Zhou-
dc.contributor.authorSong, Yong-Chun-
dc.contributor.authorTao, Zhen-
dc.contributor.authorZhao, Lu-Jun-
dc.contributor.authorMeng, Mao-Bin-
dc.contributor.authorKong Feng-Ming Spring-
dc.contributor.authorYuan, Zhi-Yong-
dc.date.accessioned2024-06-18T03:42:56Z-
dc.date.available2024-06-18T03:42:56Z-
dc.date.issued2024-01-01-
dc.identifier.citationRadiotherapy & Oncology, 2024, v. 190-
dc.identifier.issn0167-8140-
dc.identifier.urihttp://hdl.handle.net/10722/343934-
dc.description.abstract<h3>Objectives</h3><p>Examine the significance of contouring the brachial plexus (BP) for toxicity estimation and select metrics for predicting radiation-induced brachial plexopathy (RIBP) after stereotactic body radiotherapy.</p><h3>Materials and Methods</h3><p>Patients with planning target volume (PTV) ≤ 2 cm from the BP were eligible. The BP was contoured primarily according to the RTOG 1106 atlas, while subclavian-axillary veins (SAV) were contoured according to RTOG 0236. Apical PTVs were classified as anterior (PTV-A) or posterior (PTV-B) PTVs. Variables predicting grade 2 or higher RIBP (RIBP2) were selected through least absolute shrinkage and selection operator regression and logistic regression.</p><h3>Results</h3><p>Among 137 patients with 140 BPs (median follow-up, 32.1 months), 11 experienced RIBP2. For patients with RIBP2, the maximum physical dose to the BP (BP-D<sub>max</sub>) was 46.5 Gy (median; range, 35.7 to 60.7 Gy). Of these patients, 54.5 % (6/11) satisfied the RTOG limits when using SAV delineation; among them, 83.3 % (5/6) had PTV-B. For patients with PTV-B, the maximum physical dose to SAV (SAV-D<sub>max</sub>) was 11.2 Gy (median) lower than BP-D<sub>max</sub>. Maximum and 0.3 cc biologically effective doses to the BP based on the linear-quadratic-linear model (BP-BED<sub>max LQL</sub> and BP-BED<sub>0.3cc LQL</sub>, α/β = 3) were selected as predictive variables with thresholds of 118 and 73 Gy, respectively.</p><h3>Conclusion</h3><p>Contouring SAV may significantly underestimate the RIBP2 risk in dosimetry, especially for patients with PTV-B. BP contouring indicated BP-BED<sub>0.3cc LQL</sub> and BP-BED<sub>max LQL</sub> as potential predictors of RIBP2.</p>-
dc.languageeng-
dc.publisherElsevier-
dc.relation.ispartofRadiotherapy & Oncology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectBrachial plexopathy-
dc.subjectDelineation-
dc.subjectDosimetric analysis-
dc.subjectStereotactic body radiotherapy-
dc.titleDosimetric analysis of brachial plexopathy after stereotactic body radiotherapy: Significance of organ delineation-
dc.typeArticle-
dc.identifier.doi10.1016/j.radonc.2023.110023-
dc.identifier.scopuseid_2-s2.0-85178331755-
dc.identifier.volume190-
dc.identifier.issnl0167-8140-

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