Geometric dose prediction model for hemithoracic intensity-modulated radiation therapy in mesothelioma patients with two intact lungs

Li Cheng Kuo, Ellen D. Yorke, Vishruta A. Dumane, Amanda Foster, Zhigang Zhang, James G. Mechalakos, Abraham J. Wu, Kenneth E. Rosenzweig, Andreas Rimner

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The presence of two intact lungs makes it challenging to reach a tumoricidal dose with hemithoracic pleural intensity-modulated radiation therapy (IMRT) in patients with malignant pleural mesothelioma (MPM) who underwent pleurectomy/decortications or have unresectable disease. We developed an anatomy-based model to predict attainable prescription dose before starting optimization. Fifty-six clinically delivered IMRT plans were analyzed regarding correlation of prescription dose and individual and total lung volumes, planning target volume (PTV), ipsilateral normal lung volume and ratios: contralateral/ipsilateral lung (CIVR); contralateral lung/PTV (CPVR); ipsilateral lung /PTV (IPVR); ipsilateral normal lung /total lung (INTLVR); ipsilateral normal lung/PTV (INLPVR). Spearman's rank correlation and Fisher's exact test were used. Correlation between mean ipsilateral lung dose (MILD) and these volume ratios and between prescription dose and single lung mean doses were studied. The prediction models were validated in 23 subsequent MPM patients. CIVR showed the strongest correlation with dose (R = 0.603, p < 0.001) and accurately predicted prescription dose in the validation cases. INLPVR and MILD as well as MILD and prescription dose were significantly correlated (R = -0.784, p < 0.001 and R = 0.554, p < 0.001, respectively) in the training and validation cases. Parameters obtainable directly from planning scan anatomy predict achievable prescription doses for hemithoracic IMRT treatment of MPM patients with two intact lungs.

Original languageEnglish
Pages (from-to)371-379
Number of pages9
JournalJournal of Applied Clinical Medical Physics
Volume17
Issue number3
DOIs
StatePublished - 2016

Keywords

  • Dose prediction model
  • Intensity-modulated radiation therapy (IMRT)
  • Malignant pleural mesothelioma (MPM)

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