Okumuş, Dilruba2023-01-192023-01-192017-02-06Okumuş, D. vd. (2017). ''The relationship between dosimetric factors, side effects, and survival in patients with non-small cell lung cancer treated with definitive radiotherapy''. Medical Dosimetry, 42(3), 169-176.0958-3947https://doi.org/10.1016/j.meddos.2017.02.002https://www.sciencedirect.com/science/article/abs/pii/S09583947173002011873-4022http://hdl.handle.net/11452/30566The patients with non small cell lung cancer (NSCLC) treated with definitive conformal radiotherapy (RT) were evaluated in terms of side effects and survival. Normal tissue complication probability (NTCP) was calculated for 68 patients treated between 2009 and 2012. Clinical and dosimetric factors were analyzed. The median dose of 63 Gy (range: 54 to 70 Gy) was given with conformal RT with blocks (n = 37), 3-dimensional conformal RT (3DCRT) (n =11), or intensity-modulated RT (IMRT) (n = 20). Acute grade 1 to 2 radiation pneumonitis (RP) was seen in 13% of the patients. No significant relationship was found between RP and treatment and dosimetric factors (p > 0.05). There was a positive correlation between median "mean lung dose" (MLD) (17 Gy), lung V30 (20.5%), and NTCP (14%) (p < 0.001). Median and 2-year overall survival (OS) and progression-free survival (PFS) were 27 and 18 months and 51% and 42%, respectively. In univariate analysis, significant dose range for survival was found between 59.4 and 63 Gy (p < 0.01). In multivariate analysis, response (p = 0.001), fraction dose of 1.8 Gy (p = 0.002), MLD <18 Gy (p = 0.04) for OS and response (p < 0.001), total dose > 59.4 Gy (p = 0.01), and tumor biologically effective dose (BED)3(Gy) 5100.8 (p = 0.01) for PFS were found to be favorable factors. In our study, we found a linear correlation between NTCP and MLD for RP risk estimation in patients with NSCLC. Therapeutic dose range where MLD can be kept under 20 Gy with significant survival benefit was found between 59.4 and 63 Gy. Increased therapeutic efficacy will be possible using risk-adaptive RT techniques.eninfo:eu-repo/semantics/closedAccessOncologyRadiology, nuclear medicine & medical imagingDefinitive conformal radiotherapyDosimetric factorsRadiation pneumonitisSide effectsSurvivalDose-volume histogramIntensity-modulated radiotherapyRadiation pneumonitisParametersEscalationToxicityRiskAdultAgedAged, 80 and overCarcinoma, non-small-cell lungFemaleHumansLung neoplasmsMaleMiddle agedRadiotherapy dosageRadiotherapy, intensity-modulatedRetrospective studiesTurkeyArticle0004114242000022-s2.0-8501891582716917642328506589OncologyRadiology, nuclear medicine & medical imagingNon-Small Cell Lung Carcinoma; Esophagitis; Lung InjuryCarboplatinCisplatinDocetaxelPaclitaxelAdrenal insufficiencyAdrenal metastasisAdultAgedArticleBone metastasisBrain metastasisCancer radiotherapyCancer survivalClinical effectivenessConformal radiotherapyControlled studyDisease severityDosimetryEffective dose (radiation)FemaleHerpes zosterHumanIntensity modulated radiation therapyLeukopenialiver metastasisLung fibrosisLung volumeMajor clinical studyMaleMedian survival timeNon small cell lung cancerOverall survivalPericardial effusionPericardiocentesisPriority journalProgression free survivalRadiation doseRadiation dose distributionRadiation hazardRadiation pneumoniaRadiation safetyRadiological parametersRetrospective studySmokingSoft tissue metastasisSquamous cell lung carcinomaStandardized uptake valueTreatment responseEpidemiologyLung tumorMiddle agedMortalityNon small cell lung cancerRadiotherapy dosageStatistics and numerical dataVery elderly