Radiobiological analysis of stereotactic body radiation therapy for an evidence-based planning target volume of the lung using multiphase CT images obtained with a pneumatic abdominal compression apparatus: a case study

Arun, C. O.; Goel, Harish Chandra; Jain, Sandeep Kumar; Kumar, Pawan

doi:10.1007/s12194-017-0431-4

Cited by 3 publications

(4 citation statements)

References 35 publications

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“…Independent t-tests were performed to compare groups. There was no statistical difference seen in NTCP LUNG or NTCP CW between tumour stage status (grouped generically by T1, T2 and T3 rather than using sub-group categorisation such as T1aN0M0, for example), between male and female groups or by fractionation 2,4,8 with the exception of the 3 # and 5 # (t-test, t 187 = 2•808, p = 0•006) where the mean NTCP LUNG for 3 # was 3•2% compared with the 2•3% for 5 # patients.…”

Section: Resultsmentioning

confidence: 92%

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Normal tissue complication probabilities of lung SABR patients from a UK centre and its implication on personalised radiotherapy

Marsden

2022

J Radiother Pract

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Introduction: This work reports on the normal tissue complication probabilities (NTCP) from a UK cohort of previously treated peripheral lung SABR patients (n = 198) supplementing our previous publication on tumour control probabilities (TCP). Each patient was recalculated for alternative schedules. Materials and Methods: NTCP for 3 (54 Gy), 5 (55 and 60 Gy) and 8 (50 Gy) fraction (#) schemes were calculated with the Lyman Kutcher Burman (LKB) model in the software platform ‘Biosuite’ (Version 12·01) for lung and chest wall. Patients treated with 5 # or 8 # were then recomputed for alternative fractionations and doses (3 # and 5 #, for both 55 Gy and 60 Gy). Results: The mean lung NTCP (NTCPLUNG, for the outcome of radiation pneumonitis) was 2·8% (range 0·6 – 10·6). The mean chest wall NTCP (NTCPCW, for the outcome of rib fracture) was 1·4% (range 0·0–55·9). There were no statistically significant differences observed between male and female, tumour status or fractionation groups except for the NTCPLUNG between 5 # and 3 #. When recalculating NTCP and TCP individually, for 8 # patients, no differences were observed between mean TCP, NTCPLUNG or NTCPCW compared with 3 # or 5 # indicating that fractionation reduction is possible. Parity was observed between the 60 Gy group when recalculated for 55 Gy. For the 60 Gy in 5 # group, the NTCPCW increased significantly when recalculated for 3 #. Conclusion: NTCPs achievable with current UK planning techniques have been presented indicating SABR Consortium compliant centres are likely to have low complication population risks (< 3 %). 5 # schedules could be justified for 8 # patients, thereby reducing the number of treatment visits. Where there is a large overlap of PTV and chest wall, this indicates an NTCP/TCP calculation is required to investigate if fractionation reduction is individually appropriate.

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Section: Resultsmentioning

confidence: 92%

“…For the chest wall, the end point was chosen as rib fracture also using the LKB model with the parameters as in Chairmadurai et al 8 and Stam et al, 9 with the parameters α/β = 3 Gy, TD50 = 65•0 Gy, n = 1 (parallel organ), m = 0•3.…”

Section: Methodsmentioning

confidence: 99%

Normal tissue complication probabilities of lung SABR patients from a UK centre and its implication on personalised radiotherapy

Marsden

2022

J Radiother Pract

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“…In peripheral lung lesions, TCP got significantly enhanced to 0.6% for long-term (>5years; p<0.05), and NTCP was significantly reduced in patients with Grade ≥ II pneumonitis (0.2%; p<0.05). Although, in central lung lesions, TCP got enhanced insignificantly however NTCPs got reduced significantly [15] for cartilage necrosis and myelitis. Post treatment follow up of patient using positron emission tomography fused with computed tomography up to 12 months post treatment revealed no residual tumors in the treatment beds of any of the patient analyzed as per the Response Evaluation Criteria.…”

Section: Introductionmentioning

confidence: 89%

“…Internal treatment volume (ITV) within which the tumor moves within thoracic region was also monitored. Based on delineating ITV, SBRT was delivered to tumors [15] which reduced bystander toxicity by 15%. Combining RapidArc technique with SBRT reduced the exposure time and toxicity to normal tissues with rapid exponential dose fall-off than [22][23][24][25] conventional radiotherapy techniques.…”

Section: Introductionmentioning

confidence: 99%

Ra-SBRT is Potential Immune Adjuvant for Innate Immune Cell Populations in Advance Stage NSCLC Patients

Arun

2019

J. Anal. Oncol.

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Bystander toxicity and tissue fibrosis are the major complications with conventional radiation therapy for cancer patients. In this context, we here propose RapidArc -Stereotactic Body Radiation Therapy (Ra-SBRT) as a noninvasive and immune adjuvant approach for the successful eradication of advance stage NSCLC. Ra-SBRT is highly focused and capable of destroying tumors with high grade metastatic lesions and spared normal tissues. Follow up of stage 4th NSCLC patient revealed that Ra-SBRT is potentially immunogenic which was evident by increased number of iNOS+ Tumor Associated macrophages (M1-TAM), Siglac-8+ eosinophils, basophils and subsequent prolongation of disease free survival of 4th stage NSCLC patients by 3 years. This study demonstrated M1 retuning potential of Ra-SBRT which is a pre-requisite of effective management of inoperable and highly metastatic tumors of lung with least or no bystander impact.

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Rapid Arc-SBRT: Non-Invasive Immune Adjuvant for Advanced Stage Non-Small Cell Lung Carcinoma

Arun

Jain

et al. 2022

ACAMC

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: In conjunction with Radio-chemotherapy, pulmonary resection is recommended for early-stage Non-small-cell lung carcinoma but not for advanced-stage NSCLC patients with having high-grade metastatic lesions. In these cases, Rapid Arc-Stereotactic body radiotherapy (Ra-SBRT) technique offers a therapeutic advantage by delivering focal irradiation to metastatic lung lesions and reduces the bystander toxicity to normal tissues. We have previously demonstrated that Ra-SBRT ablates metastatic lesions and induces tumor immune rejection of metastatic tumors by promoting in situ programming of M2 TAM towards M1-TAM and infiltration of Siglec-8+ Eosinophils. Most interestingly, Ra SBRT has very low abscopal impact and spares normal tissues, which are the significant limitations with conventional radiotherapy. In view of this and Immune adjuvant potential of Ra SBRT, it promotes normalization of aberrant vasculature and inhibits the metastatic potential of NSCLC lesions. In view of this we here propose that Ra-SBRT indeed represents an immunogenic approach for the effective management of advanced-stage NSCLC.

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Radiobiological analysis of stereotactic body radiation therapy for an evidence-based planning target volume of the lung using multiphase CT images obtained with a pneumatic abdominal compression apparatus: a case study

Cited by 3 publications

References 35 publications

Normal tissue complication probabilities of lung SABR patients from a UK centre and its implication on personalised radiotherapy

Normal tissue complication probabilities of lung SABR patients from a UK centre and its implication on personalised radiotherapy

Ra-SBRT is Potential Immune Adjuvant for Innate Immune Cell Populations in Advance Stage NSCLC Patients

Rapid Arc-SBRT: Non-Invasive Immune Adjuvant for Advanced Stage Non-Small Cell Lung Carcinoma

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