How Does the Gradient Measure of the Lung SBRT Treatment Plan Depend on the Tumor Volume and Shape?

Abstract

PurposeGradient measure (GM) is a critical index related to normal tissue sparing in radiosurgery. This study aims to describe the dependence of GM on target volume and target shape for lung stereotactic body radiation therapy (SBRT) treatment plans.MethodsA total of 307 peripheral and 119 central lung SBRT treatment plans were enrolled for this study. A least-squares regression was used for data analysis. First, the equations with different functional forms were established to determine the dependence of GM on a univariaty (VP or Sp) and bivariaty (VP and Sp), respectively. Then, the correlation coefficients and p-values of variables for all equations were compared and analyzed to determine the dependence of GM on PTV volume (VP) and sphericity (Sp).ResultsThe power equations had the highest coefficient of determination (R2) in the dependence results of GM on univariate VP. The equations were GM=0.674VP0.178 and GM=0.660VP0.185 for peripheral and central lesions, respectively. On the other hand, the R2 of all functional forms were less than 0.25 when the relationship of GM versus univariate Sp was analyzed. Similarly, the power equation also obtained the highest R2 in bivariaty VP and Sp analysis, whether for central or peripheral. However, the R2 of the bivariate equations were not improved compared with those of univariate equations. Moreover, the p-values of the variable Sp were greater than 0.05.ConclusionsThe GM of the lung SBRT plan is shape-independent and volume-dependent. The dependence of GM on PTV volume for peripheral and central lung cancer can be described by two different power equations. The results of this study can be used as a potential tool to assist dosimetric quality control during the radiosurgery process.

A novel dose fall‐off index and preliminary application in brain and lung stereotactic radiotherapy

“…The dose fall-off were affected by delivery machines/techniques, energy modality, arrangements of radiation beams, number of isocenters, etc. 28,29 Although the values of D 2cm seemed more scattered owing to the variable PTV shape in Figure 2 (i), it had stronger correlation with the PTV volume than GI and R 50% . The relationships between GI/R 50% and PTV volume were not statistically significant, as shown in Figure 2 (g) and (h).…”

“…Therefore, when clinical plans do not satisfy the fitted formula, oncologists and dosimetrists should comprehensively evaluate these plans and decide whether they can be delivered to patients or if slight modification is required. The dose fall‐off were affected by delivery machines/techniques, energy modality, arrangements of radiation beams, number of isocenters, etc 28,29 …”