| Deng Hongbin,Gong Guanzhong,Chen Jinhu,Duan Jinghao,Yin Yong.The study of the feasibility of dose escalation guided by 18F-FDG PET/CT for high metabolic region in radiotherapy of locally advanced non-small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection,2017,37(10):747-751 |
| The study of the feasibility of dose escalation guided by 18F-FDG PET/CT for high metabolic region in radiotherapy of locally advanced non-small cell lung cancer |
| Received:April 01, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.10.005 |
| KeyWords:Dose escalation Non-small cell lung cancer Sub-volume 18F-FDG PET/CT Radiotherapy |
| FundProject:国家自然科学基金（81301936，81472811）；山东省科技发展计划项目（2014GGC03038） |
| Author Name | Affiliation | E-mail | | Deng Hongbin | School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250022, China | | | Gong Guanzhong | Department of Radiation Physics and Technology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China | | | Chen Jinhu | Department of Radiation Physics and Technology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China | | | Duan Jinghao | Department of Radiation Physics and Technology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China | | | Yin Yong | Department of Radiation Physics and Technology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China | yongyinsd@163.com |
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| Abstract:: |
| Objective To investigate dose escalation by metabolic sub-volume based on standard uptake values (SUV) gradient of pre-treatment positron emission tomography/computed tomography (PET/CT) for locally advanced non-small cell lung cancer (NSCLC) radiotherapy.Methods The pre-treatment 18F-FDG PET/CT images of 29 patients with locally advanced NSCLC were analyzed retrospectively. Gross tumor volume (GTV) was delineated on the PET/CT fusion images. Tumor metabolic sub-volume was segmented according to the threshold of 50% and 75% maximum standard uptake values (SUVmax). The region that under 50% SUVmax was defined as GTV1. From 50% to 75% SUVmax was defined as GTV2,and over 75% SUVmax was defined as GTV3. PTV (planning target volume), PTV1, PTV2 and PTV3 were extended from GTV, GTV1, GTV2 and GTV3, and different plans were designed subsequently. Plan 1 was designed for PTV with prescription dose 60 Gy, and Plan 2 was designed for PTV1, PTV2 and PTV3 with prescription dose 60-66 Gy, 66-72 Gy and ≥ 72 Gy, respectively. The dosimetric parameters between tumor target and organs at risk (OARs) were compared.Results Compared to Plan 1, the absorbed dose in Plan 2 that covers 2% volume of the PTV (D2) was increased from 66.5 Gy to 78.5 Gy and the dose was escalated by about 23.2%. The average dose of PTV1, PTV2 and PTV3 increased by 2.8% (62.7-64.4 Gy), 10.3% (63.5-70.0 Gy), 18.7% (63.8-75.8 Gy), and the average dose of PTV increased by 8.9% (63.2-68.8 Gy). The sub-regional dose had been effectively improved. There was no significant difference in target coverage between Plan 1 and Plan 2 (P>0.05). Homogeneity index(HI) was decreased with the escalation of maximum dose for Plan 2(t=23.3, P<0.05). There was no statistically significant difference in radiation dose of OARs between two plans(P>0.05).Conclusions Dose escalation based on metabolic sub-volume from 18F-FDG PET/CT was feasible, and radiation dose escalation of sub-volume with high metabolic activity can be achieved without increasing the OARs dose. |
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