Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma

Jacqueline C.M. Theuws; Stefan L.S. Kwa; Antoinette C. Wagenaar; Yvette Seppenwoolde; Liesbeth J. Boersma; Eugene M.F. Damen; Sara H. Muller; Paul Baas; Joos V. Lebesque

doi:10.1016/S0167-8140(98)00117-0

Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma

Jacqueline C.M. Theuws, Stefan L.S. Kwa, Antoinette C. Wagenaar, Yvette Seppenwoolde, Liesbeth J. Boersma, Eugene M.F. Damen, Sara H. Muller, Paul Baas, Joos V. Lebesque^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

73 Citations (Scopus)

Abstract

Purpose: To predict the changes in pulmonary function tests (PFTs) 3-4 months after radiotherapy based on the three-dimensional (3-D) dose distribution and taking into account patient- and treatment-related factors. Methods: For 81 patients with malignant lymphoma and breast cancer, PFTs (V(A), VC, FEV₁ and T(L,COc) were performed prior to and 3-4 months after irradiation and dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction were determined using correlated CT and SPECT data. The 3-D dose distribution of each patient was converted into four different dose-volume parameters, i.e. the mean dose in the lung and three overall response parameters (ORPs, which represent the average local injury over the complete lung). ORPs were determined using the dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction. Correlation coefficients were calculated between these dose-volume parameters and the changes in PFTs. In addition, the impact of the variables chemotherapy (MOPP/ABV and CMF), tamoxifen, smoking, age and gender on the relation between the mean lung dose and the relative changes in PFTs following radiotherapy was studied using multiple regression analysis. Results: The mean lung dose proved to be the easiest parameter to predict the reduction in PFTs 3-4 months following radiotherapy. For all patients the relation between the mean lung dose and the changes in PFTs could be described with one regression line through the origin and a slope of 1% reduction in PFT for each increase of 1 Gy in mean lung dose. Smoking and CMF chemotherapy influenced the reduction in PFTs significantly for V(A) and T(L,COc), respectively. Patients treated with MOPP/ABV prior to radiotherapy had lower pre-radiotherapy PFTs than other patient groups, but did not show further deterioration after radiotherapy (at 3-4 months). Conclusions: The relative reduction in V(A), VC, FEV₁ and T(L,COc) 3-4 months after radiotherapy for breast cancer and malignant lymphoma can be estimated before radiotherapy based on the mean lung dose of each individual patient and taking into account the use of chemotherapy and smoking habits of the patient.

Original language	English
Pages (from-to)	233-243
Number of pages	11
Journal	Radiotherapy and Oncology
Volume	49
Issue number	3
DOIs	https://doi.org/10.1016/S0167-8140(98)00117-0
Publication status	Published - 1 Dec 1998
Externally published	Yes

Bibliographical note

Funding Information:
The authors wish to thank Dr H. Bartelink and Dr B. Mijnheer for critical reading of the manuscript, the nuclear technologists, who assisted in SPECT data acquisition, M. Meyer, who performed the pulmonary function tests, and Ir. A.A.M. Hart for statistical advice. We are grateful to Dr R.A. Valdés Olmos for useful discussions. This work was supported by the Dutch Cancer Society (Grant NKI 94-819).

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10.1016/S0167-8140(98)00117-0

Cite this

Theuws, J. C. M., Kwa, S. L. S., Wagenaar, A. C., Seppenwoolde, Y., Boersma, L. J., Damen, E. M. F., Muller, S. H., Baas, P., & Lebesque, J. V. (1998). Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma. Radiotherapy and Oncology, 49(3), 233-243. https://doi.org/10.1016/S0167-8140(98)00117-0

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title = "Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma",

abstract = "Purpose: To predict the changes in pulmonary function tests (PFTs) 3-4 months after radiotherapy based on the three-dimensional (3-D) dose distribution and taking into account patient- and treatment-related factors. Methods: For 81 patients with malignant lymphoma and breast cancer, PFTs (V(A), VC, FEV1 and T(L,COc) were performed prior to and 3-4 months after irradiation and dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction were determined using correlated CT and SPECT data. The 3-D dose distribution of each patient was converted into four different dose-volume parameters, i.e. the mean dose in the lung and three overall response parameters (ORPs, which represent the average local injury over the complete lung). ORPs were determined using the dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction. Correlation coefficients were calculated between these dose-volume parameters and the changes in PFTs. In addition, the impact of the variables chemotherapy (MOPP/ABV and CMF), tamoxifen, smoking, age and gender on the relation between the mean lung dose and the relative changes in PFTs following radiotherapy was studied using multiple regression analysis. Results: The mean lung dose proved to be the easiest parameter to predict the reduction in PFTs 3-4 months following radiotherapy. For all patients the relation between the mean lung dose and the changes in PFTs could be described with one regression line through the origin and a slope of 1% reduction in PFT for each increase of 1 Gy in mean lung dose. Smoking and CMF chemotherapy influenced the reduction in PFTs significantly for V(A) and T(L,COc), respectively. Patients treated with MOPP/ABV prior to radiotherapy had lower pre-radiotherapy PFTs than other patient groups, but did not show further deterioration after radiotherapy (at 3-4 months). Conclusions: The relative reduction in V(A), VC, FEV1 and T(L,COc) 3-4 months after radiotherapy for breast cancer and malignant lymphoma can be estimated before radiotherapy based on the mean lung dose of each individual patient and taking into account the use of chemotherapy and smoking habits of the patient.",

author = "Theuws, {Jacqueline C.M.} and Kwa, {Stefan L.S.} and Wagenaar, {Antoinette C.} and Yvette Seppenwoolde and Boersma, {Liesbeth J.} and Damen, {Eugene M.F.} and Muller, {Sara H.} and Paul Baas and Lebesque, {Joos V.}",

note = "Funding Information: The authors wish to thank Dr H. Bartelink and Dr B. Mijnheer for critical reading of the manuscript, the nuclear technologists, who assisted in SPECT data acquisition, M. Meyer, who performed the pulmonary function tests, and Ir. A.A.M. Hart for statistical advice. We are grateful to Dr R.A. Vald{\'e}s Olmos for useful discussions. This work was supported by the Dutch Cancer Society (Grant NKI 94-819).",

year = "1998",

month = dec,

day = "1",

doi = "10.1016/S0167-8140(98)00117-0",

language = "English",

volume = "49",

pages = "233--243",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

number = "3",

}

Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma. / Theuws, Jacqueline C.M.; Kwa, Stefan L.S.; Wagenaar, Antoinette C. et al.
In: Radiotherapy and Oncology, Vol. 49, No. 3, 01.12.1998, p. 233-243.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma

AU - Theuws, Jacqueline C.M.

AU - Kwa, Stefan L.S.

AU - Wagenaar, Antoinette C.

AU - Seppenwoolde, Yvette

AU - Boersma, Liesbeth J.

AU - Damen, Eugene M.F.

AU - Muller, Sara H.

AU - Baas, Paul

AU - Lebesque, Joos V.

N1 - Funding Information: The authors wish to thank Dr H. Bartelink and Dr B. Mijnheer for critical reading of the manuscript, the nuclear technologists, who assisted in SPECT data acquisition, M. Meyer, who performed the pulmonary function tests, and Ir. A.A.M. Hart for statistical advice. We are grateful to Dr R.A. Valdés Olmos for useful discussions. This work was supported by the Dutch Cancer Society (Grant NKI 94-819).

PY - 1998/12/1

Y1 - 1998/12/1

N2 - Purpose: To predict the changes in pulmonary function tests (PFTs) 3-4 months after radiotherapy based on the three-dimensional (3-D) dose distribution and taking into account patient- and treatment-related factors. Methods: For 81 patients with malignant lymphoma and breast cancer, PFTs (V(A), VC, FEV1 and T(L,COc) were performed prior to and 3-4 months after irradiation and dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction were determined using correlated CT and SPECT data. The 3-D dose distribution of each patient was converted into four different dose-volume parameters, i.e. the mean dose in the lung and three overall response parameters (ORPs, which represent the average local injury over the complete lung). ORPs were determined using the dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction. Correlation coefficients were calculated between these dose-volume parameters and the changes in PFTs. In addition, the impact of the variables chemotherapy (MOPP/ABV and CMF), tamoxifen, smoking, age and gender on the relation between the mean lung dose and the relative changes in PFTs following radiotherapy was studied using multiple regression analysis. Results: The mean lung dose proved to be the easiest parameter to predict the reduction in PFTs 3-4 months following radiotherapy. For all patients the relation between the mean lung dose and the changes in PFTs could be described with one regression line through the origin and a slope of 1% reduction in PFT for each increase of 1 Gy in mean lung dose. Smoking and CMF chemotherapy influenced the reduction in PFTs significantly for V(A) and T(L,COc), respectively. Patients treated with MOPP/ABV prior to radiotherapy had lower pre-radiotherapy PFTs than other patient groups, but did not show further deterioration after radiotherapy (at 3-4 months). Conclusions: The relative reduction in V(A), VC, FEV1 and T(L,COc) 3-4 months after radiotherapy for breast cancer and malignant lymphoma can be estimated before radiotherapy based on the mean lung dose of each individual patient and taking into account the use of chemotherapy and smoking habits of the patient.

AB - Purpose: To predict the changes in pulmonary function tests (PFTs) 3-4 months after radiotherapy based on the three-dimensional (3-D) dose distribution and taking into account patient- and treatment-related factors. Methods: For 81 patients with malignant lymphoma and breast cancer, PFTs (V(A), VC, FEV1 and T(L,COc) were performed prior to and 3-4 months after irradiation and dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction were determined using correlated CT and SPECT data. The 3-D dose distribution of each patient was converted into four different dose-volume parameters, i.e. the mean dose in the lung and three overall response parameters (ORPs, which represent the average local injury over the complete lung). ORPs were determined using the dose-effect relations for early changes in local perfusion, ventilation and air-filled fraction. Correlation coefficients were calculated between these dose-volume parameters and the changes in PFTs. In addition, the impact of the variables chemotherapy (MOPP/ABV and CMF), tamoxifen, smoking, age and gender on the relation between the mean lung dose and the relative changes in PFTs following radiotherapy was studied using multiple regression analysis. Results: The mean lung dose proved to be the easiest parameter to predict the reduction in PFTs 3-4 months following radiotherapy. For all patients the relation between the mean lung dose and the changes in PFTs could be described with one regression line through the origin and a slope of 1% reduction in PFT for each increase of 1 Gy in mean lung dose. Smoking and CMF chemotherapy influenced the reduction in PFTs significantly for V(A) and T(L,COc), respectively. Patients treated with MOPP/ABV prior to radiotherapy had lower pre-radiotherapy PFTs than other patient groups, but did not show further deterioration after radiotherapy (at 3-4 months). Conclusions: The relative reduction in V(A), VC, FEV1 and T(L,COc) 3-4 months after radiotherapy for breast cancer and malignant lymphoma can be estimated before radiotherapy based on the mean lung dose of each individual patient and taking into account the use of chemotherapy and smoking habits of the patient.

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DO - 10.1016/S0167-8140(98)00117-0

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AN - SCOPUS:0032428271

SN - 0167-8140

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JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

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ER -

Prediction of overall pulmonary function loss in relation to the 3-D dose distribution for patients with breast cancer and malignant lymphoma

Abstract

Bibliographical note

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