[Lung dose constraints for normo-fractionated radiotherapy and for stereotactic body radiation therapy]

E Blais; B Pichon; A Mampuya; M Antoine; P Lagarde; G Kantor; C Breton-Callu; C Lefebvre; M Gerard; A Aamarcha; M Ozsahin; J Bourhis; P Maingon; I Troussier; N Pourel

doi:10.1016/j.canrad.2017.07.046

[Lung dose constraints for normo-fractionated radiotherapy and for stereotactic body radiation therapy]

Cancer Radiother. 2017 Oct;21(6-7):584-596. doi: 10.1016/j.canrad.2017.07.046. Epub 2017 Sep 5.

[Article in French]

Authors

E Blais¹, B Pichon², A Mampuya², M Antoine³, P Lagarde³, G Kantor³, C Breton-Callu³, C Lefebvre⁴, M Gerard², A Aamarcha³, M Ozsahin², J Bourhis², P Maingon⁵, I Troussier⁵, N Pourel⁶

Affiliations

¹ Service de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France. Electronic address: [email protected].
² Service de radio-oncologie, CHUV, rue du Bugnon 46, 1011 Lausanne, Suisse.
³ Service de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
⁴ Service de maladies respiratoires, CHU Bordeaux, avenue de Magellan, 33604 Pessac, France.
⁵ Service de radiothérapie, groupe hospitalier universitaire Pitié-Salpétrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
⁶ Service de radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, 84918 Avignon, France.

PMID: 28886981
DOI: 10.1016/j.canrad.2017.07.046

Abstract

Radiation-induced lung disease (RILD) is common after radiation therapy and represents cornerstone toxicities after treatment of thoracic malignancies. From a review of literature, the objective of this article was to summarize clinical and non-clinical parameters associated with the risk of RILD in the settings of normo-fractionated radiotherapy and stereotactic body radiation therapy (SBRT). For the treatment of lung cancers with a normo-fractionated treatment, the mean lung dose (MLD) should be below 15-20Gy. For a thoracic SBRT, V20Gy<10% and MLD<6Gy are recommended. One should pay attention to central tumors and respect specific dose constraints to the bronchial tree. The recent technological improvements may represent an encouraging way to decrease lung toxicities. Finally, our team developed a calculator in order to predict the risk of radiation pneumonitis.

Keywords: Dose constraints; Doses de tolérance; Lung; Normo-fractionated radiotherapy; Organ at risk; Organe à risque; Poumons; Radiothérapie conformationnelle; Radiothérapie stéréotaxique; Stereotactic body radiation therapy.

Publication types

Review

MeSH terms

Dose Fractionation, Radiation*
Humans
Lung / radiation effects*
Lung Diseases / etiology*
Lung Neoplasms / radiotherapy*
Organs at Risk / radiation effects*
Radiation Pneumonitis / etiology
Radiosurgery / methods*
Thoracic Neoplasms / radiotherapy