2023 World Conference on Lung Cancer (Posters)-EP08.02. Dosimetric Contribution of LAD Sparing Radiotherapy Plan in Patients with Postoperative Lung Cancer

EP08.02. Dosimetric Contribution of LAD Sparing Radiotherapy Plan in Patients with Postoperative Lung Cancer - PDF(Slides)

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This study aimed to evaluate the dosimetric contribution of a left anterior descending coronary artery (LAD) sparing radiotherapy plan in patients with postoperative lung cancer. The goal was to reduce the volume of LAD receiving a dose of 15Gy or more (LAD-V15 ≥ 10%) without compromising target volume and other organ at risk (OAR) dose limitation parameters.<br /><br />A total of 30 patients who received postoperative radiotherapy for non-small cell lung cancer (NSCLC) were analyzed. LAD contouring was manually done for each patient, and 17 patients were selected based on their LAD-V15 ≥ 10% value. New radiotherapy plans were then made by optimizing the LAD while maintaining optimal target volume and OAR doses.<br /><br />Previous radiotherapy plans consisted of 3D radiotherapy (3DRT) in 3 patients, intensity-modulated radiotherapy (IMRT) in 7 patients, and a combination of 3DRT and IMRT in 7 patients. The mean LAD-V15 value of these patients was 38%. After replanning with optimization of LAD-V15 ≤ 10%, 88% of the plans were performed with IMRT and 12% with a combination of 3DRT and IMRT. The mean LAD-V15 value in the new plans was significantly reduced to 8%.<br /><br />For 71% of the patients, the LAD-V15 value was successfully reduced below 10%. In the remaining 5 patients, the mean LAD-V15 value was significantly reduced. The mean cardiac dose and V30 values were also reduced in the new plans, while there was no significant difference in lung V20 and mean lung dose.<br /><br />In conclusion, LAD sparing radiotherapy plan optimization can effectively reduce the volume of LAD receiving a high dose while still maintaining target coverage and meeting standard OAR dose constraints. However, in patients who received radiotherapy to all lymphatic stations in the left mediastinum, achieving the targeted LAD-V15 value was challenging.

Asset Subtitle

Serap Akyürek

Meta Tag

Speaker Serap Akyürek

Topic Local-Regional NSCLC: Multimodality Therapy

Keywords

dosimetric contribution

left anterior descending coronary artery

LAD sparing radiotherapy plan

postoperative lung cancer

LAD-V15

non-small cell lung cancer

radiotherapy plans

3D radiotherapy

intensity-modulated radiotherapy

OAR dose limitation