Regional Lung Density Changes After Radiation Therapy for Tumors in and Around Thorax

Jinli Ma, Junan Zhang, Sumin Zhou, Jessica L. Hubbs, Rodney J. Foltz, Donna R. Hollis, Kim L. Light, Terence Z. Wong, Christopher R. Kelsey, Lawrence B. Marks

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Purpose: To study the temporal nature of regional lung density changes and to assess whether the dose-dependent nature of these changes is associated with patient- and treatment-associated factors. Methods and Materials: Between 1991 and 2004, 118 patients with interpretable pre- and post-radiation therapy (RT) chest computed tomography (CT) scans were evaluated. Changes in regional lung density were related to regional dose to define a dose-response curve (DRC) for RT-induced lung injury using three-dimensional planning tools and image fusion. Multiple post-RT follow-up CT scans were evaluated by fitting linear-quadratic models of density changes on dose with time as the covariate. Various patient- and treatment-related factors were examined as well. Results: There was a dose-dependent increase in regional lung density at nearly all post-RT follow-up intervals. The population volume-weighted changes evolved over the initial 6-month period after RT and reached a plateau thereafter (p < 0.001). On univariate analysis, patient age greater than 65 years (p = 0.003) and/or the use of pre-RT surgery (p < 0.001) were associated with significantly greater changes in CT density at both 6 and 12 months after RT, but the magnitude of this effect was modest. Conclusions: There appears to be a temporal nature for the dose-dependent increases in lung density. Nondosimetric clinical factors tend to have no, or a modest, impact on these changes.

Original languageEnglish (US)
Pages (from-to)116-122
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume76
Issue number1
DOIs
StatePublished - Jan 2010

Keywords

  • Computed tomography
  • Dose-response curve
  • Lung density

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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