Dataset Information

Differential inflammatory response dynamics in normal lung following stereotactic body radiation therapy with protons versus photons.

ABSTRACT:

Background and purpose

To compare time-dependent changes in lung parenchyma of early-stage non-small cell lung carcinoma (NSCLC) patients after stereotactic body radiation therapy with protons (SBPT) or photons (SBRT).

Materials and method

We retrospectively identified NSCLC patients treated with SBPT and matched each one with a SBRT patient by patient, tumor, and treatment characteristics. Lung parenchyma on serial post-treatment chest computer tomography (CT) scans was deformably registered with the treatment plan to analyze lung density changes as function of dose, quantified by Houndsfield Unit (HU)/Gy. A thoracic radiologist also evaluated the CTs using an established grading system.

Results

We matched 23 SBPT/SBRT pairs, including 5 patients treated with both modalities (internally matched cohort). Normal lung response following SBPT significantly increased in the early time period (CTs acquired <6 months, median 3 months) post-treatment, and then did not change significantly in the later time period (CTs acquired 6-14 months, median 9 months). For SBRT, the normal lung response was similar to SBPT in the early time period, but then increased significantly from the early to the late time period (p = 0.007). These differences were most pronounced in sensitive (response >6 HU/Gy) patients and in the internally matched cohort. However, there was no significant difference in the maximum observed response in the entire cohort over all time periods, median 3.4 [IQR, 1.0-5.4] HU/Gy (SBPT) versus 2.5 [1.6-5.2] HU/Gy (SBRT). Qualitative radiological evaluation was highly correlated with the quantitative analysis (p < 0.0001).

Conclusion

While there was no significant difference in maximum response after SBPT versus SBRT, dose-defined lung inflammation occurred earlier after proton irradiation. Further investigation is warranted into the mechanisms of inflammation and therapeutic consequences after proton versus photon irradiation.

SUBMITTER: Li Y

PROVIDER: S-EPMC6592748 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Differential inflammatory response dynamics in normal lung following stereotactic body radiation therapy with protons versus photons.

Li Yanjing Y Dykstra Michael M Best Till D TD Pursley Jennifer J Chopra Nitish N Keane Florence K FK Khandekar Melin J MJ Sharp Gregory C GC Paganetti Harald H Willers Henning H Fintelmann Florian J FJ Grassberger Clemens C

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 20190420

<h4>Background and purpose</h4>To compare time-dependent changes in lung parenchyma of early-stage non-small cell lung carcinoma (NSCLC) patients after stereotactic body radiation therapy with protons (SBPT) or photons (SBRT).<h4>Materials and method</h4>We retrospectively identified NSCLC patients treated with SBPT and matched each one with a SBRT patient by patient, tumor, and treatment characteristics. Lung parenchyma on serial post-treatment chest computer tomography (CT) scans was deformabl ...[more]

PMID: 31015121

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Dataset Information

Differential inflammatory response dynamics in normal lung following stereotactic body radiation therapy with protons versus photons.

Background and purpose

Materials and method

Results

Conclusion

Publications

Differential inflammatory response dynamics in normal lung following stereotactic body radiation therapy with protons versus photons.

Similar Datasets

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