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Retrospective estimation of heart and lung doses in pediatric patients treated with spinal irradiation

Artikel i vetenskaplig tidskrift
Författare D. Gasic
P. M. af Rosenschold
I. R. Vogelius
M. V. Maraldo
M. C. Aznar
K. Nysom
Thomas Björk-Eriksson
S. M. Bentzen
N. P. Brodin
Publicerad i Radiotherapy and Oncology
Volym 128
Nummer/häfte 2
Sidor 209-213
ISSN 0167-8140
Publiceringsår 2018
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för onkologi
Sidor 209-213
Språk en
Länkar dx.doi.org/10.1016/j.radonc.2018.05...
Ämnesord Pediatric spinal irradiation, Retrospective dosimetry, Heart and lungs, Linear regression models, Dose, disease following treatment, childhood-cancer survivor, breast-cancer, radiation-therapy, hodgkins-disease, radiotherapy, chemotherapy, reconstruction, lymphoma, women
Ämneskategorier Radiologi och bildbehandling, Cancer och onkologi

Sammanfattning

Background and purpose: The purpose of this study was to investigate whether treatment information from medical records can be used to estimate radiation doses to heart and lungs retrospectively in pediatric patients receiving spinal irradiation with conventional posterior fields. Material and methods: An algorithm for retrospective dosimetry in children treated with spinal irradiation was developed in a cohort of 21 pediatric patients with available CT-scans and treatment plans. We developed a multivariable linear regression model with explanatory variables identifiable in case note review for retrospective estimation of minimum, maximum, mean and V-10%-V-80% doses to the heart and lungs. Doses were estimated for both linear accelerator (Linac) and Co-60 radiation therapy modalities. Results: Age and spinal field width were identified as statistically significant predictors of heart and lung doses in multivariable analyses (p < 0.01 in all models). Models showed excellent predictive performance with R-2 = 0.70 for mean heart dose and 0.79 for mean lung dose, for Linac plans. In leave-one-out cross-validation analysis the average difference between predicted and actual mean heart dose was 6.7% and 7.6% of the prescription dose for Linac and Co-60 plans, respectively, and 5.2% and 4.9% for mean lung dose. Due to the small sample size and large inter-patient variation in heart and lung dose, prospective studies validating these findings are highly warranted. Conclusions: The models presented here provide retrospective estimates of heart and lung doses for historical cohorts of pediatric patients, thus facilitating studies of long-term adverse effects of radiation. (C) 2018 Elsevier B.V. All rights reserved.

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