Comparing different NTCP models that predict the incidence of radiation pneumonitis

Seppenwoolde, Yvette; Lebesque, Joos V.; Jaeger, Katrien De; Belderbos, J.; Boersma, Liesbeth; Schilstra, Cornelis; Henning, G.; Hayman, James A.; Martel, Mary K.; Haken, Randall K. Ten

doi:10.1016/s0360-3016(02)03986-x

Cited by 419 publications

(363 citation statements)

References 27 publications

Supporting

Mentioning

336

Contrasting

Unclassified

Order By: Relevance

“…Thus, 20 Gy, 30%, and 30% were used as cut-points for these three metrics, respectively, to define the patient subgroups in this study. These cut-points are consistent with prior analyses [3,4,8,10]. The cut-point used for GTV was 100 cm 3 , which corresponded with the median value.…”

Section: Patient Subgroupssupporting

confidence: 83%

“…Several studies have successfully correlated the risk of developing RT-induced lung injury with 3D dose parameters such as mean lung dose (MLD) and the percentage of lung volume receiving ≥ 20 Gy (V20) [4,[7][8][9][10][11]. These findings are encouraging, in that they demonstrate the ability of 3D tools to predict normal tissue risks [9].…”

Section: Introductionmentioning

confidence: 92%

“…However, dosimetric parameters alone are not ideal predictors for lung injury [4,[8][9][10][11]. Several recent studies have investigated transforming growth factor-beta-1 (TGF-β1) as a predictor for RT-induced lung injury [1,3,7,[12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

et al. 2006

View full text Add to dashboard Cite

The purpose of the study was to reassess the utility of transforming growth factor-beta-1 (TGF-β1) together with dosimetric and tumor parameters as a predictor for radiation pneumonitis (RP). Of the 121 patients studied, 32 (26.4%) developed grade ≥ 1 RP, and 27 (22.3%) developed grade ≥ 2 RP. For the endpoint of grade ≥ 1 RP, those with V30 > 30% and an end-RT/baseline TGF-β1 ratio ≥ 1 had a significantly higher incidence of RP than did those with V30 > 30% and an end-RT/baseline TGF-β1 ratio < 1. For most other patient groups, there were no clear associations between TGF-β1 values and rates of RP. These findings suggest that TGF-β1 is generally not predictive for RP except for the group of patients with a high V30.

show abstract

Section: Patient Subgroupssupporting

confidence: 83%

Section: Introductionmentioning

confidence: 92%

See 1 more Smart Citation

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

et al. 2006

View full text Add to dashboard Cite

show abstract

“…For each set of DVHs, Fig. 2 also displays the mean NTCP model predictions based on SDR parameter sets from four different sources ( 17 , 22 – 24 ) and one CV parameter set (7) . For the shown parameter sets, the estimated mean probability of lung pneumonitis ranges from 0.4% to 4.3% for the “5‐field” technique; a similar probability of pneumonitis is predicted with the “wide‐tangent” technique, with corresponding mean NTCPs ranging from 0.4% to 4.0%.…”

Section: Resultsmentioning

confidence: 99%

“…In recent years, a number of works have provided parameter estimates, including statistical uncertainties, for several different normal tissues. Recent SDR model parameter estimates include those for the parotid gland, ( 18 – 20 ) the heart, (21) the lung, ( 22 – 24 ) and the liver (25) (26) For further details (e.g., treatment techniques, parameters) about the clinical data on which each of these parameter estimates is based, the reader is referred to the original papers.…”

Section: Methodsmentioning

confidence: 99%

A TCP‐NTCP estimation module using DVHs and known radiobiological models and parameter sets

Warkentin

Stavrev

Stavreva

et al. 2004

J Applied Clin Med Phys

View full text Add to dashboard Cite

Radiotherapy treatment plan evaluation relies on an implicit estimation of the tumor control probability (TCP) and normal tissue complication probability (NTCP) arising from a given dose distribution. A potential application of radiobiological modeling to radiotherapy is the ranking of treatment plans via a more explicit determination of TCP and NTCP values. Although the limited predictive capabilities of current radiobiological models prevent their use as a primary evaluative tool, radiobiological modeling predictions may still be a valuable complement to clinical experience. A convenient computational module has been developed for estimating the TCP and the NTCP arising from a dose distribution calculated by a treatment planning system, and characterized by differential (frequency) dose‐volume histograms (DDVHs). The radiobiological models included in the module are sigmoidal dose response and Critical Volume NTCP models, a Poisson TCP model, and a TCP model incorporating radiobiological parameters describing linear‐quadratic cell kill and repopulation. A number of sets of parameter values for the different models have been gathered in databases. The estimated parameters characterize the radiation response of several different normal tissues and tumor types. The system also allows input and storage of parameters by the user, which is particularly useful because of the rapidly increasing number of parameter estimates available in the literature. Potential applications of the system include the following: comparing radiobiological predictions of outcome for different treatment plans or types of treatment; comparing the number of observed outcomes for a cohort of patient DVHs to the predicted number of outcomes based on different models/parameter sets; and testing of the sensitivity of model predictions to uncertainties in the parameter values. The module thus helps to amalgamate and make more accessible current radiobiological modeling knowledge, and may serve as a useful aid in the prospective and retrospective analysis of radiotherapy treatment plans.PACS number: 87.53.Tf

show abstract

Effect of Midtreatment PET/CT-Adapted Radiation Therapy With Concurrent Chemotherapy in Patients With Locally Advanced Non–Small-Cell Lung Cancer

et al. 2017

Self Cite

View full text Add to dashboard Cite

IMPORTANCE Our previous studies demonstrated that tumors significantly decrease in size and metabolic activity after delivery of 45 Gy of fractionated radiatiotherapy (RT), and that metabolic shrinkage is greater than anatomic shrinkage. This study aimed to determine whether 18F-fludeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) acquired during the course of treatment provides an opportunity to deliver higher-dose radiation to the more aggressive areas of the tumor to improve local tumor control without increasing RT-induced lung toxicity (RILT), and possibly improve survival. OBJECTIVE To determine whether adaptive RT can target high-dose radiation to the FDG-avid tumor on midtreatment FDG-PET to improve local tumor control of locally advanced non–small-cell lung cancer (NSCLC). DESIGN, SETTING, AND PARTICIPANTS A phase 2 clinical trial conducted at 2 academic medical centers with 42 patients who had inoperable or unresectable stage II to stage III NSCLC enrolled from November 2008, to May 2012. Patients with poor performance, more than 10% weight loss, poor lung function, and/or oxygen dependence were included, providing that the patients could tolerate the procedures of PET scanning and RT. INTERVENTION Conformal RT was individualized to a fixed risk of RILT (grade >2) and adaptively escalated to the residual tumor defined on midtreatment FDG-PET up to a total dose of 86 Gy in 30 daily fractions. Medically fit patients received concurrent weekly carboplatin plus paclitaxel followed by 3 cycles of consolidation. MAIN OUTCOMES AND MEASURES The primary end point was local tumor control. The trial was designed to achieve a 20% improvement in 2-year control from 34% of our prior clinical trial experience with 63 to 69 Gy in a similar patient population. RESULTS The trial reached its accrual goal of 42 patients: median age, 63 years (range, 45–83 years); male, 28 (67%); smoker or former smoker, 39 (93%); stage III, 38 (90%). Median tumor dose delivered was 83 Gy (range, 63–86 Gy) in 30 daily fractions. Median follow-up for surviving patients was 47 months. The 2-year rates of infield and overall local regional tumor controls (ie, including isolated nodal failure) were 82% (95% CI, 62%–92%) and 62% (95% CI, 43%–77%), respectively. Median overall survival was 25 months (95% CI, 12–32 months). The 2-year and 5-year overall survival rates were 52% (95% CI, 36%–66%) and 30% (95% CI, 16%–45%), respectively. CONCLUSIONS AND RELEVANCE Adapting RT-escalated radiation dose to the FDG-avid tumor detected by midtreatment PET provided a favorable local-regional tumor control. The RTOG 1106 trial is an ongoing clinical trial to validate this finding in a randomized fashion. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01190527

show abstract

Comparing different NTCP models that predict the incidence of radiation pneumonitis

Cited by 419 publications

References 27 publications

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

A TCP‐NTCP estimation module using DVHs and known radiobiological models and parameter sets

Effect of Midtreatment PET/CT-Adapted Radiation Therapy With Concurrent Chemotherapy in Patients With Locally Advanced Non–Small-Cell Lung Cancer

Contact Info

Product

Resources

About