Functional lung avoidance and response-adaptive escalation (FLARE) RT: Multimodality plan dosimetry of a precision radiation oncology strategy.

ABSTRACT:

Purpose

Nonsmall cell lung cancer (NSCLC) patient radiation therapy (RT) is planned without consideration of spatial heterogeneity in lung function or tumor response. We assessed the dosimetric and clinical feasibility of functional lung avoidance and response-adaptive escalation (FLARE) RT to reduce dose to [^99m Tc]MAA-SPECT/CT perfused lung while redistributing an escalated boost dose within [¹⁸ F]FDG-PET/CT-defined biological target volumes (BTV).

Methods

Eight stage IIB-IIIB NSCLC patients underwent FDG-PET/CT and MAA-SPECT/CT treatment planning scans. Perfused lung objectives were derived from scatter/collimator/attenuation-corrected MAA-SPECT uptake relative to ITV-subtracted lung to maintain < 20 Gy mean lung dose (MLD). Prescriptions included 60

SUBMITTER: Lee E 

PROVIDER: S-EPMC5546910 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature