Liver dosimetric evaluation in biologically based stereotactic body radiotherapy for large inoperable hepatocellular carcinoma View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-06

AUTHORS

Shaun K. Loewen, Emily Vollans, Catherine Crumley, Hardeep Sahota, Robert Kosztyla, Mitchell Liu, Devin Schellenberg, Marie-Laure Camborde, Cheryl Duzenli, Vitali Moiseenko, Mohamed Khan, Roy Ma

ABSTRACT

Individualized dose prescription for liver stereotactic body radiotherapy (SBRT) requires effective volume calculation and biological modeling to estimate the risk of liver injury. This study determined dose-volumetric (DV) parameters associated with low risk for radiation-induced liver disease (RILD) derived from normal tissue complication probability (NTCP) modeling with three-fraction and five-fraction SBRT for hepatocellular carcinomas (HCCs) > 5 cm. Prescription dose was 24–36 Gy in three fractions and 40–45 Gy in five fractions. Effective volume was determined for 20 liver SBRT plans using the linear-quadratic (LQ) equation. Lyman-Kutcher-Burman NTCP model estimated the risk of liver toxicity. Mean dose to normal liver (MLD) was tabulated from plans associated with < 6 % toxicity prediction. Sensitivity analysis of model parameters and DV relationships to critical volume constraints was performed. Median normal liver volume was 1144 cm3 (710–2916 cm3) and the median planning target volume (PTV) was 633 cm3 (186–2388 cm3). MLD predicting low hepatic toxicity for three-fraction SBRT plans was 13.8 ± 0.6 Gy, while MLD from five-fraction SBRT plans was 16.1 ± 1.0 Gy. Lower n, α/β, and D50 parameters and a higher m parameter increased %RILD, and vice versa. An estimated 1200 cm3 of normal liver was needed in 7 of 10 three-fraction plans for very large tumors to functionally preserve 700 cm3and 800 cm3 to ≤ 15 and ≤ 18 Gy, respectively. MLD values derived for three-fraction and five-fraction SBRT by the NTCP method were consistent with established SBRT liver dose constraints. However, SBRT for large hepatocellular carcinomas may be limited by critical volume dose objectives. More... »

PAGES

177-184

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s13566-015-0195-6

DOI

http://dx.doi.org/10.1007/s13566-015-0195-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1004118660


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