2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.08C.02 Impact of Non-Coplanar Radiation Beam Geometry on Effective Dose to Immune Cells (EDIC) In Stage III NSCLC

EP.08C.02 Impact of Non-Coplanar Radiation Beam Geometry on Effective Dose to Immune Cells (EDIC) In Stage III NSCLC

Pdf Summary

This study from the Winship Cancer Institute of Emory University explores the impact of non-coplanar radiation beam geometry on the effective dose to immune cells (EDIC) in patients with stage III non-small cell lung cancer (NSCLC). The primary objective was to evaluate how changing the radiation beam geometry could improve EDIC and potentially enhance overall survival in these patients.<br /><br />The study was a single-institution, multi-center, retrospective analysis, focusing on patients treated with volumetric modulated arc therapy (VMAT) photon radiation plans, initially using co-planar beam geometries. These clinically delivered plans (CDPs) were then replanned using a novel non-coplanar oblique arc-based VMAT approach (NCPs) that strategically limited radiation exposure to the heart through optimal couch rotations.<br /><br />Key findings include:<br />- Non-coplanar VMAT beam geometry led to a significant reduction in the mean heart dose (MHD) compared to the traditional coplanar setups, while the mean lung dose (MLD) remained largely unaffected.<br />- EDIC values were significantly lower with non-coplanar plans, indicating less impact on the immune system.<br />- An improvement in modeled two-year overall survival (OS) was observed, up from 54.60% with standard plans to 57.50% with the non-coplanar replan, suggesting a 2.9% projected OS benefit.<br /><br />The study concludes that utilizing non-coplanar oblique VMAT beam geometry can enhance MHD, EDIC, and two-year OS metrics without significantly increasing MLD. The findings suggest that adopting these techniques could potentially improve clinical outcomes, though further investigation into their real-world implications is needed.

Asset Subtitle

Benjamin Hopkins

Meta Tag

Speaker Benjamin Hopkins

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

non-coplanar radiation

immune cells

stage III NSCLC

volumetric modulated arc therapy

VMAT

mean heart dose

overall survival

Winship Cancer Institute

non-coplanar beam geometry

retrospective analysis