Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Organs at Risk Considerations for Thoracic Stereotactic Body Radiation Therapy: What Is Safe for Lung Parenchyma?

Publication ,  Journal Article
Kong, F-MS; Moiseenko, V; Zhao, J; Milano, MT; Li, L; Rimner, A; Das, S; Li, XA; Miften, M; Liao, Z; Martel, M; Bentzen, SM; Jackson, A ...
Published in: Int J Radiat Oncol Biol Phys
May 1, 2021

PURPOSE: Stereotactic body radiation therapy (SBRT) has become the standard of care for inoperable early-stage non-small cell lung cancer and is often used for recurrent lung cancer and pulmonary metastases. Radiation-induced lung toxicity (RILT), including radiation pneumonitis and pulmonary fibrosis, is a major concern for which it is important to understand dosimetric and clinical predictors. METHODS AND MATERIALS: This study was undertaken through the American Association of Physicists in Medicine's Working Group on Biological Effects of Stereotactic Body Radiotherapy. Data from studies of lung SBRT published through the summer of 2016 that provided detailed information about RILT were analyzed. RESULTS: Ninety-seven studies were ultimately considered. Definitions of the risk organ and complication endpoints as well as dose-volume information presented varied among studies. The risk of RILT, including radiation pneumonitis and pulmonary fibrosis, was reported to be associated with the size and location of the tumor. Patients with interstitial lung disease appear to be especially susceptible to severe RILT. A variety of dosimetric parameters were reported to be associated with RILT. There was no apparent threshold "tolerance dose-volume" level. However, most studies noted safe treatment with a rate of symptomatic RILT of <10% to 15% after lung SBRT with a mean lung dose (MLD) of the combined lungs ≤8 Gy in 3 to 5 fractions and the percent of total lung volume receiving more than 20 Gy (V20) <10% to 15%. CONCLUSIONS: To allow more rigorous analysis of this complication, future studies should standardize reporting by including standardized endpoint and volume definitions and providing dose-volume information for all patients, with and without RILT.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

May 1, 2021

Volume

110

Issue

1

Start / End Page

172 / 187

Location

United States

Related Subject Headings

  • Tumor Burden
  • Risk Factors
  • Re-Irradiation
  • Radiotherapy Dosage
  • Radiosurgery
  • Radiation Tolerance
  • Radiation Pneumonitis
  • Pulmonary Fibrosis
  • Organs at Risk
  • Oncology & Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kong, F.-M., Moiseenko, V., Zhao, J., Milano, M. T., Li, L., Rimner, A., … Yorke, E. (2021). Organs at Risk Considerations for Thoracic Stereotactic Body Radiation Therapy: What Is Safe for Lung Parenchyma? Int J Radiat Oncol Biol Phys, 110(1), 172–187. https://doi.org/10.1016/j.ijrobp.2018.11.028
Kong, Feng-Ming Spring, Vitali Moiseenko, Jing Zhao, Michael T. Milano, Ling Li, Andreas Rimner, Shiva Das, et al. “Organs at Risk Considerations for Thoracic Stereotactic Body Radiation Therapy: What Is Safe for Lung Parenchyma?Int J Radiat Oncol Biol Phys 110, no. 1 (May 1, 2021): 172–87. https://doi.org/10.1016/j.ijrobp.2018.11.028.
Kong F-MS, Moiseenko V, Zhao J, Milano MT, Li L, Rimner A, et al. Organs at Risk Considerations for Thoracic Stereotactic Body Radiation Therapy: What Is Safe for Lung Parenchyma? Int J Radiat Oncol Biol Phys. 2021 May 1;110(1):172–87.
Kong, Feng-Ming Spring, et al. “Organs at Risk Considerations for Thoracic Stereotactic Body Radiation Therapy: What Is Safe for Lung Parenchyma?Int J Radiat Oncol Biol Phys, vol. 110, no. 1, May 2021, pp. 172–87. Pubmed, doi:10.1016/j.ijrobp.2018.11.028.
Kong F-MS, Moiseenko V, Zhao J, Milano MT, Li L, Rimner A, Das S, Li XA, Miften M, Liao Z, Martel M, Bentzen SM, Jackson A, Grimm J, Marks LB, Yorke E. Organs at Risk Considerations for Thoracic Stereotactic Body Radiation Therapy: What Is Safe for Lung Parenchyma? Int J Radiat Oncol Biol Phys. 2021 May 1;110(1):172–187.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

May 1, 2021

Volume

110

Issue

1

Start / End Page

172 / 187

Location

United States

Related Subject Headings

  • Tumor Burden
  • Risk Factors
  • Re-Irradiation
  • Radiotherapy Dosage
  • Radiosurgery
  • Radiation Tolerance
  • Radiation Pneumonitis
  • Pulmonary Fibrosis
  • Organs at Risk
  • Oncology & Carcinogenesis