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The Effect of Dose Prescriptions On Tumor Local Control and Normal Tissue Complication Probability Prediction in Stereotactic Body Radiotherapy for Non-Small Cell Lung Cancer

BT Huang, JY Lu, WZ Zhang*, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong

Presentations

(Sunday, 7/29/2018) 3:00 PM - 6:00 PM

Room: Exhibit Hall

Purpose: Stereotactic body radiotherapy (SBRT) for medically inoperable patients with stage I non-small cell lung cancer (NSCLC) has achieved encouraging outcome, however, the wide variation of dose prescriptions lead to significant difference of the maximum dose in the tumor which is reported to be correlated with local control (LC). The aim of the study is to investigate the effect of dose prescription on LC and related toxicities prediction using radiobiological analysis.

Methods: Computed tomography (CT) simulation data for 20 patients previously diagnosed with primary stage I NSCLC were included in the study. Treatment plans based on four dose schedules of 1×30 Gy, 3×15 Gy, 4×12 Gy and 3×18 Gy were designed. Four dose prescriptions (120%, 115%, 110% and 105% of the prescribed dose) were generated in each dose schedule to investigate their influence on LC and related toxicities. 3-year LC, radiation-induced pneumonitis (RIP), chest wall pain (CWP) and radiation-induced rib fracture (RIRF) were predicted with radiobiological models.

Results: We found that different dose prescriptions influenced the LC data by less than 1% in the employed four dose schedules. However, higher dose prescription increased by up to 4.1%, 2.7% and 4.8% probability of RIP, CWP and RIRF respectively in the employed four dose schedules.

Conclusion: Different dose prescriptions principally influence the risk of RIP, CWP and RIRF whereas have slight impact on LC.

Funding Support, Disclosures, and Conflict of Interest: This work was sponsored by National Natural Science Foundation of China (81602667) and Medical Scientific Research Foundation of Guangdong Province (A2015534, B2016048).

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