Martel M K, Ten Haken R K, Hazuka M B, Turrisi A T, Fraass B A, Lichter A S
Department of Radiation Oncology, University of Michigan, Ann Arbor 48109.
Int J Radiat Oncol Biol Phys. 1994 Feb 1;28(3):575-81. doi: 10.1016/0360-3016(94)90181-3.
Tolerance of normal lung to inhomogeneous irradiation of partial volumes is not well understood. This retrospective study analyzes three-dimensional (3-D) dose distributions and dose-volume histograms for 63 patients who have had normal lung irradiated in two types of treatment situations.
3-D treatment plans were examined for 21 patients with Hodgkin's disease and 42 patients with nonsmall-cell lung cancer. All patients were treated with conventional fractionation, with a dose of 67 Gy (corrected) or higher for the lung cancer patients. A normal tissue complication probability description and a dose-volume histogram reduction scheme were used to assess the data. Mean dose to lung was also calculated.
Five Hodgkin's disease patients and nine lung cancer patients developed pneumonitis. Data were analyzed for each individual independent lung and for the total lung tissue (lung as a paired organ). Comparisons of averages of mean lung dose and normal tissue complication probabilities show a difference between patients with and without complications. Averages of calculated normal tissue complication probabilities for groups of patients show that empirical model parameters correlate with actual complication rates for the Hodgkin's patients, but not as well for the individual lungs of the lung cancer patients treated to larger volumes of normal lung and high doses.
This retrospective study of the 3-D dose distributions for normal lung for two types of treatment situations for patients with irradiated normal lung gives useful data for the characterization of the dose-volume relationship and the development of pneumonitis. These data can be used to help set up a dose escalation protocol for the treatment of nonsmall-cell lung cancer.
正常肺组织对部分体积不均匀照射的耐受性尚未得到充分了解。这项回顾性研究分析了63例在两种治疗情况下接受正常肺组织照射的患者的三维（3-D）剂量分布和剂量体积直方图。
对21例霍奇金病患者和42例非小细胞肺癌患者的三维治疗计划进行了检查。所有患者均采用常规分割治疗，肺癌患者的剂量为67 Gy（校正后）或更高。使用正常组织并发症概率描述和剂量体积直方图简化方案来评估数据。还计算了肺的平均剂量。
5例霍奇金病患者和9例肺癌患者发生了肺炎。对每个独立的肺以及整个肺组织（作为成对器官的肺）的数据进行了分析。平均肺剂量和正常组织并发症概率平均值的比较显示有并发症和无并发症患者之间存在差异。患者组计算出的正常组织并发症概率平均值表明，经验模型参数与霍奇金病患者的实际并发症发生率相关，但对于接受较大正常肺体积和高剂量治疗的肺癌患者的个体肺组织，相关性则没那么好。
这项对接受正常肺组织照射的患者在两种治疗情况下正常肺组织三维剂量分布的回顾性研究，为表征剂量体积关系和肺炎的发生提供了有用的数据。这些数据可用于帮助制定非小细胞肺癌治疗的剂量递增方案。
