Kori Kilgar , John San Miguel , Ahmar Abbas , Zishan Allibhai , Mojgan Taremi , Tatiana Conrad , Natalie Rozanec
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V5 lung dose levels, treated planning target volume (PTV) cord length, patient-reported ESAS scores at the time of radiation oncology consultation, 3 months’ post-treatment, and 6 months’ post-treatment were analyzed. All symptoms on the ESAS survey were investigated, but shortness of breath (SOB) scores were the main focus of this study. Date of death for each patient was also included for analysis.</p></div><div><h3>Results</h3><p>Patients treated with a VMAT technique had significantly higher V5 lung dose levels compared to those treated conventionally (right lung: <em>p</em> = 1.67e-14; left lung: <em>p</em> = 1.33e-6). Despite this, no significant differences were observed for SOB scores at all time points between groups and conventionally treated patients reported significantly worse pain, tiredness, depression, and wellbeing scores. A moderate correlation was observed between PTV length and nausea, SOB, appetite, and drowsiness scores in the VMAT group. Treatment technique was not found to have a significant impact on patient lifespan.</p></div><div><h3>Conclusions</h3><p>Despite higher V5 lung dose levels associated with a VMAT technique, no significant differences were found in patient-reported ESAS scores compared to patients treated with conventional techniques. This demonstrates that palliation of thoracic spinal metastases is feasible and safe using a VMAT technique.</p></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dosimetric analysis of patients receiving volumetric-modulated arc palliative radiotherapy to the thoracic spine: A comparison with conventional mono-isocentric parallel opposed pair treatment\",\"authors\":\"Kori Kilgar , John San Miguel , Ahmar Abbas , Zishan Allibhai , Mojgan Taremi , Tatiana Conrad , Natalie Rozanec\",\"doi\":\"10.1016/j.jmir.2024.04.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>Volumetric modulated arc therapy (VMAT) has allowed for dose escalation and a decrease in radiation-induced toxicities for a variety of treatment sites, including spinal metastases. 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引用次数: 0
摘要
目的:容积调制弧线疗法(VMAT)可使各种治疗部位(包括脊柱转移瘤)的剂量升级,并减少放射引起的毒性。本文将比较VMAT和传统胸椎治疗对患者正常肺组织的剂量影响,并确定患者报告的埃德蒙顿症状评估系统(ESAS)评分是否存在显著差异:这项回顾性质量保证研究确定了288名接受胸椎姑息放疗的患者,这些患者使用了VMAT或传统计划技术,并采用了不同的姑息剂量分割方案。研究分析了V5肺部剂量水平、治疗计划靶体积(PTV)线长、放射肿瘤科会诊时患者报告的ESAS评分、治疗后3个月和治疗后6个月的ESAS评分。本研究调查了 ESAS 调查中的所有症状,但呼吸急促(SOB)评分是本研究的重点。每位患者的死亡日期也被纳入分析范围:结果:与常规治疗相比,采用 VMAT 技术治疗的患者的 V5 肺剂量水平明显更高(右肺:p = 1.67e-14;左肺:p = 1.33e-6)。尽管如此,各组患者在所有时间点的 SOB 评分均无明显差异,而接受常规治疗的患者的疼痛、疲倦、抑郁和幸福感评分明显更差。在 VMAT 组中,PTV 长度与恶心、SOB、食欲和嗜睡评分之间存在中度相关性。治疗技术对患者的寿命没有显著影响:结论:尽管VMAT技术的V5肺剂量水平更高,但与采用传统技术治疗的患者相比,患者报告的ESAS评分没有发现明显差异。这表明使用 VMAT 技术治疗胸椎转移瘤是可行且安全的。
Dosimetric analysis of patients receiving volumetric-modulated arc palliative radiotherapy to the thoracic spine: A comparison with conventional mono-isocentric parallel opposed pair treatment
Purpose
Volumetric modulated arc therapy (VMAT) has allowed for dose escalation and a decrease in radiation-induced toxicities for a variety of treatment sites, including spinal metastases. This article will compare the dosimetric impacts on normal lung tissue in patients treated with both VMAT and conventional treatment to the thoracic spine and determine if any significant difference exists among patient reported Edmonton Symptom Assessment System (ESAS) scores.
Methods
This retrospective quality assurance study identified 288 patients who received palliative radiotherapy to the thoracic spine using VMAT or conventional planning techniques with various palliative dose fractionation schemes. V5 lung dose levels, treated planning target volume (PTV) cord length, patient-reported ESAS scores at the time of radiation oncology consultation, 3 months’ post-treatment, and 6 months’ post-treatment were analyzed. All symptoms on the ESAS survey were investigated, but shortness of breath (SOB) scores were the main focus of this study. Date of death for each patient was also included for analysis.
Results
Patients treated with a VMAT technique had significantly higher V5 lung dose levels compared to those treated conventionally (right lung: p = 1.67e-14; left lung: p = 1.33e-6). Despite this, no significant differences were observed for SOB scores at all time points between groups and conventionally treated patients reported significantly worse pain, tiredness, depression, and wellbeing scores. A moderate correlation was observed between PTV length and nausea, SOB, appetite, and drowsiness scores in the VMAT group. Treatment technique was not found to have a significant impact on patient lifespan.
Conclusions
Despite higher V5 lung dose levels associated with a VMAT technique, no significant differences were found in patient-reported ESAS scores compared to patients treated with conventional techniques. This demonstrates that palliation of thoracic spinal metastases is feasible and safe using a VMAT technique.
期刊介绍:
Journal of Medical Imaging and Radiation Sciences is the official peer-reviewed journal of the Canadian Association of Medical Radiation Technologists. This journal is published four times a year and is circulated to approximately 11,000 medical radiation technologists, libraries and radiology departments throughout Canada, the United States and overseas. The Journal publishes articles on recent research, new technology and techniques, professional practices, technologists viewpoints as well as relevant book reviews.