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2. Improving shared decision making for lung cancer treatment by developing and validating an open-source web based patient decision aid for stage I-II non-small cell lung cancer.

Author

Halilaj, Iva, Ankolekar, Anshu, Lenaers, Anouk, Chatterjee, Avishek, Oberije, Cary J. G., Eppings, Lisanne, Smit, Hans J. M., Hendriks, Lizza E. L., Jochems, Arthur, Lieverse, Relinde I. Y., van Timmeren, Janita E., Wind, Anke, and Lambin, Philippe

Subjects
LUNG physiology, TREATMENT of lung tumors, PATIENT education, WORLD Wide Web, MOBILE apps, SCALE analysis (Psychology), MEDICAL personnel, COMPUTERS, HEALTH attitudes, COMPUTER software, RESEARCH funding, INTERVIEWING, QUESTIONNAIRES, DIGITAL health, DECISION making, TREATMENT effectiveness, RADIOSURGERY, DESCRIPTIVE statistics, RESEARCH methodology, PHYSICIAN-patient relations, COMMUNICATION, LUNG tumors, QUALITY of life, LUNG cancer, TUMOR classification, CANCER patient psychology, PATIENT satisfaction, EVIDENCE-based medicine, PROGRESSION-free survival, COMPARATIVE studies, DATA analysis software, PSYCHOSOCIAL factors, INTER-observer reliability, PATIENTS' attitudes, OVERALL survival
Abstract

The aim of this study was to develop and evaluate a proof-of-concept opensource individualized Patient Decision Aid (iPDA) with a group of patients, physicians, and computer scientists. The iPDA was developed based on the International Patient Decision Aid Standards (IPDAS). A previously published questionnaire was adapted and used to test the user-friendliness and content of the iPDA. The questionnaire contained 40 multiple-choice questions, and answers were given on a 5-point Likert Scale (1-5) ranging from "strongly disagree" to "strongly agree." In addition to the questionnaire, semi-structured interviews were conducted with patients. We performed a descriptive analysis of the responses. The iPDA was evaluated by 28 computer scientists, 21 physicians, and 13 patients. The results demonstrate that the iPDA was found valuable by 92% (patients), 96% (computer scientists), and 86% (physicians), while the treatment information was judged useful by 92%, 96%, and 95%, respectively. Additionally, the tool was thought to be motivating for patients to actively engage in their treatment by 92%, 93%, and 91% of the above respondents groups. More multimedia components and less text were suggested by the respondents as ways to improve the tool and user interface. In conclusion, we successfully developed and tested an iPDA for patients with stage I-II Non-Small Cell Lung Cancer (NSCLC). [ABSTRACT FROM AUTHOR]

Published
2024
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4. Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Van Limbergen, Evert J., Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Hendriks, Lizza E. L., Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, de Jong, Monique C., Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, De Ruysscher, Dirk, Dubois, Ludwig J., and Lambin, Philippe

Published
2020
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6. Radiomics: from qualitative to quantitative imaging

Author

Rogers, William, Rogers, William, Seetha, Sithin Thulasi, Refaee, Turkey A. G., Lieverse, Relinde I. Y., Granzier, Renee W. Y., Ibrahim, Abdalla, Keek, Simon A., Sanduleanu, Sebastian, Primakov, Sergey P., Beuque, Manon P. L., Marcus, Damienne, van der Wiel, Alexander M. A., Zerka, Fadila, Oberije, Cary J. G., van Timmeren, Janita E., Woodruff, Henry C., Lambin, Philippe, Rogers, William, Rogers, William, Seetha, Sithin Thulasi, Refaee, Turkey A. G., Lieverse, Relinde I. Y., Granzier, Renee W. Y., Ibrahim, Abdalla, Keek, Simon A., Sanduleanu, Sebastian, Primakov, Sergey P., Beuque, Manon P. L., Marcus, Damienne, van der Wiel, Alexander M. A., Zerka, Fadila, Oberije, Cary J. G., van Timmeren, Janita E., Woodruff, Henry C., and Lambin, Philippe

Abstract

Historically, medical imaging has been a qualitative or semi-quantitative modality. It is difficult to quantify what can be seen in an image, and to turn it into valuable predictive outcomes, As a result of advances in both computational hardware and machine learning algorithms, computers are making great strides in obtaining quantitative information from imaging and correlating it with outcomes, Radiomics, in its two forms "handcrafted and deep," is an emerging field that translates medical images into quantitative data to yield biological information and enable radiologic phenotypic profiling for diagnosis, theragnosis, decision support, and monitoring. Handcrafted radiomics is a multistage process in which features based on shape, pixel intensities, and texture are extracted from radiographs. Within this review, we describe the steps: starting with quantitative imaging data, how it can be extracted, how to correlate it with clinical and biological outcomes, resulting in models that can be used to make predictions, such as survival, or for detection and classification used in diagnostics. The application of deep learning, the second arm of radiomics, and its place in the radiomics workflow is discussed, along with its advantages and disadvantages. To better illustrate the technologies being used, we provide real-world clinical applications of radiomics in oncology, showcasing research on the applications of radiomics, as well as covering its limitations and its future direction.

Published
2020

7. Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial.

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service de radiothérapie oncologique, Lieverse, Relinde I Y, Van Limbergen, Evert J, Oberije, Cary J G, Troost, Esther G C, Hadrup, Sine R, Dingemans, Anne-Marie C, Hendriks, Lizza E L, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, de Jong, Monique C, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, De Ruysscher, Dirk, Dubois, Ludwig J, Lambin, Philippe, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service de radiothérapie oncologique, Lieverse, Relinde I Y, Van Limbergen, Evert J, Oberije, Cary J G, Troost, Esther G C, Hadrup, Sine R, Dingemans, Anne-Marie C, Hendriks, Lizza E L, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, de Jong, Monique C, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, De Ruysscher, Dirk, Dubois, Ludwig J, and Lambin, Philippe

Abstract

BACKGROUND: About 50% of non-small cell lung cancer (NSCLC) patients have metastatic disease at initial diagnosis, which limits their treatment options and, consequently, the 5-year survival rate (15%). Immune checkpoint inhibitors (ICI), either alone or in combination with chemotherapy, have become standard of care (SOC) for most good performance status patients. However, most patients will not obtain long-term benefit and new treatment strategies are therefore needed. We previously demonstrated clinical safety of the tumour-selective immunocytokine L19-IL2, consisting of the anti-ED-B scFv L19 antibody coupled to IL2, combined with stereotactic ablative radiotherapy (SABR). METHODS: This investigator-initiated, multicentric, randomised controlled open-label phase II clinical trial will test the hypothesis that the combination of SABR and L19-IL2 increases progression free survival (PFS) in patients with limited metastatic NSCLC. One hundred twenty-six patients will be stratified according to their metastatic load (oligo-metastatic: ≤5 or poly-metastatic: 6 to 10) and randomised to the experimental-arm (E-arm) or the control-arm (C-arm). The C-arm will receive SOC, according to the local protocol. E-arm oligo-metastatic patients will receive SABR to all lesions followed by L19-IL2 therapy; radiotherapy for poly-metastatic patients consists of irradiation of one (symptomatic) to a maximum of 5 lesions (including ICI in both arms if this is the SOC). The accrual period will be 2.5-years, starting after the first centre is initiated and active. Primary endpoint is PFS at 1.5-years based on blinded radiological review, and secondary endpoints are overall survival, toxicity, quality of life and abscopal response. Associative biomarker studies, immune monitoring, CT-based radiomics, stool collection, iRECIST and tumour growth rate will be performed. DISCUSSION: The combination of SABR with or without ICI and the immunocytokine L19-IL2 will be tested as 1st, 2nd or 3rd li

Published
2020

8. Radiomics: from qualitative to quantitative imaging

Author

Rogers, William, primary, Thulasi Seetha, Sithin, additional, Refaee, Turkey A. G., additional, Lieverse, Relinde I. Y., additional, Granzier, Renée W. Y., additional, Ibrahim, Abdalla, additional, Keek, Simon A., additional, Sanduleanu, Sebastian, additional, Primakov, Sergey P., additional, Beuque, Manon P. L., additional, Marcus, Damiënne, additional, van der Wiel, Alexander M. A., additional, Zerka, Fadila, additional, Oberije, Cary J. G., additional, van Timmeren, Janita E, additional, Woodruff, Henry C., additional, and Lambin, Philippe, additional

Published
2020
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9. [¹⁸F]fluorodeoxyglucose uptake patterns in lung before radiotherapy identify areas more susceptible to radiation-induced lung toxicity in non-small-cell lung cancer patients

Author

Petit, Steven F, van Elmpt, Wouter J C, Oberije, Cary J G, Vegt, Erik, Dingemans, Anne-Marie C, Lambin, Philippe, Dekker, André L A J, De Ruysscher, Dirk, Radiotherapie, Beeldvorming, MUMC+: DA BV Medische staf (6), Pulmonologie, and RS: GROW - School for Oncology and Reproduction

Subjects
Adult, Aged, 80 and over, Male, Lung Neoplasms, Research Support, Non-U.S. Gov't, Age Factors, Chemoradiotherapy, Middle Aged, Multimodal Imaging, Radiation Pneumonitis, Dyspnea, Logistic Models, Fluorodeoxyglucose F18, Carcinoma, Non-Small-Cell Lung, Positron-Emission Tomography, Odds Ratio, Journal Article, Humans, Female, Radiopharmaceuticals, Tomography, X-Ray Computed, Lung, Aged, Retrospective Studies
Abstract

PURPOSE: Our hypothesis was that pretreatment inflammation in the lung makes pulmonary tissue more susceptible to radiation damage. The relationship between pretreatment [(18)F]fluorodeoxyglucose ([(18)F]FDG) uptake in the lungs (as a surrogate for inflammation) and the delivered radiation dose and radiation-induced lung toxicity (RILT) was investigated. METHODS AND MATERIALS: We retrospectively studied a prospectively obtained cohort of 101 non-small-cell lung cancer patients treated with (chemo)radiation therapy (RT). [(18)F]FDG-positron emission tomography-computed tomography (PET-CT) scans used for treatment planning were studied. Different parameters were used to describe [(18)F]FDG uptake patterns in the lungs, excluding clinical target volumes, and the interaction with radiation dose. An increase in the dyspnea grade of 1 (Common Terminology Criteria for Adverse Events version 3.0) or more points compared to the pre-RT score was used as an endpoint for analysis of RILT. The effect of [(18)F]FDG and CT-based variables, dose, and other patient or treatment characteristics that effected RILT was studied using logistic regression. RESULTS: Increased lung density and pretreatment [(18)F]FDG uptake were related to RILT after RT with univariable logistic regression. The 95th percentile of the [(18)F]FDG uptake in the lungs remained significant in multivariable logistic regression (p = 0.016; odds ratio [OR] = 4.3), together with age (p = 0.029; OR = 1.06), and a pre-RT dyspnea score of ≥1 (p = 0.005; OR = 0.20). Significant interaction effects were demonstrated among the 80th, 90th, and 95th percentiles and the relative lung volume receiving more than 2 and 5 Gy. CONCLUSIONS: The risk of RILT increased with the 95th percentile of the [(18)F]FDG uptake in the lungs, excluding clinical tumor volume (OR = 4.3). The effect became more pronounced as the fraction of the 5%, 10%, and 20% highest standardized uptake value voxels that received more than 2 Gy to 5 Gy increased. Therefore, the risk of RILT may be decreased by applying sophisticated radiotherapy techniques to avoid areas in the lung with high [(18)F]FDG uptake.

Published
2011

10. The ESTRO Breur Lecture 2009. From population to voxel-based radiotherapy: Exploiting intra-tumour and intra-organ heterogeneity for advanced treatment of non-small cell lung cancer

Author

Lambin, Philippe, Lambin, Philippe, Petit, Steven F., Aerts, Hugo J. W. L., van Elmpt, Wouter J. C., Oberije, Cary J. G., Starmans, Maud H. W., van Stiphout, Ruud G. P. M., van Dongen, Guus A. M. S., Muylle, Kristoff, Flamen, Patrick, Dekker, Andre L. A. J., De Ruysscher, Dirk, Lambin, Philippe, Lambin, Philippe, Petit, Steven F., Aerts, Hugo J. W. L., van Elmpt, Wouter J. C., Oberije, Cary J. G., Starmans, Maud H. W., van Stiphout, Ruud G. P. M., van Dongen, Guus A. M. S., Muylle, Kristoff, Flamen, Patrick, Dekker, Andre L. A. J., and De Ruysscher, Dirk

Abstract

Evidence is accumulating that radiotherapy of non-small cell lung cancer patients can be optimized by escalating the tumour dose until the normal tissue tolerances are met To further improve the therapeutic ratio between tumour control probability and the risk of normal tissue complications, we firstly need to exploit Inter patient variation This variation arises, e g. from differences in tumour shape and size, lung function and genetic factors Secondly improvement is achieved by taking into account intra-tumour and intra-organ heterogeneity derived from molecular and functional imaging Additional radiation dose must be delivered to those parts of the tumour that need It the most, e g because of increased radio-resistance or reduced therapeutic drug uptake, and away from regions inside the lung that are most prone to complication As the delivery of these treatments plans is very sensitive for geometrical uncertainties, probabilistic treatment planning is needed to generate robust treatment plans The administration of these complicated dose distributions requires a quality assurance procedure that can evaluate the treatment delivery and, if necessary, adapt the treatment plan during radiotherapy

Published
2010

12. Additional file 4 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 4: Supplementary Table 4. Statistical analysis study parameters and subgroup analyses.

13. Additional file 5 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 5: Supplementary Table 5. Overview of the translational research samples.

14. Additional file 3 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 3: Supplementary Table 3. Schematic overview of the study and timeline.

15. Additional file 4 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 4: Supplementary Table 4. Statistical analysis study parameters and subgroup analyses.

16. Additional file 2 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 2: Supplementary Table 2. The informed consent form used for ImmunoSABR phase 2 trial.

17. Additional file 1 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 1: Supplementary Table 1. In- and exclusion criteria.

18. Additional file 5 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 5: Supplementary Table 5. Overview of the translational research samples.

19. Additional file 3 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 3: Supplementary Table 3. Schematic overview of the study and timeline.

20. Additional file 2 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 2: Supplementary Table 2. The informed consent form used for ImmunoSABR phase 2 trial.

21. Additional file 1 of Stereotactic ablative body radiotherapy (SABR) combined with immunotherapy (L19-IL2) versus standard of care in stage IV NSCLC patients, ImmunoSABR: a multicentre, randomised controlled open-label phase II trial

Author

Lieverse, Relinde I. Y., Limbergen, Evert J. Van, Oberije, Cary J. G., Troost, Esther G. C., Hadrup, Sine R., Dingemans, Anne-Marie C., Lizza E. L. Hendriks, Eckert, Franziska, Hiley, Crispin, Dooms, Christophe, Lievens, Yolande, Jong, Monique C. De, Bussink, Johan, Geets, Xavier, Valentini, Vincenzo, Elia, Giuliano, Neri, Dario, Billiet, Charlotte, Abdollahi, Amir, Pasquier, David, Boisselier, Pierre, Yaromina, Ala, Ruysscher, Dirk De, Dubois, Ludwig J., and Lambin, Philippe

Subjects
3. Good health
Abstract

Additional file 1: Supplementary Table 1. In- and exclusion criteria.

22. [¹⁸F]fluorodeoxyglucose uptake patterns in lung before radiotherapy identify areas more susceptible to radiation-induced lung toxicity in non-small-cell lung cancer patients.

Author

Petit SF, van Elmpt WJ, Oberije CJ, Vegt E, Dingemans AM, Lambin P, Dekker AL, and De Ruysscher D

Subjects
Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung metabolism, Carcinoma, Non-Small-Cell Lung radiotherapy, Chemoradiotherapy, Dyspnea etiology, Female, Humans, Logistic Models, Lung metabolism, Lung radiation effects, Lung Neoplasms metabolism, Lung Neoplasms radiotherapy, Male, Middle Aged, Multimodal Imaging methods, Odds Ratio, Positron-Emission Tomography, Radiation Pneumonitis metabolism, Retrospective Studies, Tomography, X-Ray Computed, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Fluorodeoxyglucose F18 pharmacokinetics, Lung diagnostic imaging, Lung Neoplasms diagnostic imaging, Radiation Pneumonitis diagnostic imaging, Radiopharmaceuticals pharmacokinetics
Abstract

Purpose: Our hypothesis was that pretreatment inflammation in the lung makes pulmonary tissue more susceptible to radiation damage. The relationship between pretreatment [(18)F]fluorodeoxyglucose ([(18)F]FDG) uptake in the lungs (as a surrogate for inflammation) and the delivered radiation dose and radiation-induced lung toxicity (RILT) was investigated., Methods and Materials: We retrospectively studied a prospectively obtained cohort of 101 non-small-cell lung cancer patients treated with (chemo)radiation therapy (RT). [(18)F]FDG-positron emission tomography-computed tomography (PET-CT) scans used for treatment planning were studied. Different parameters were used to describe [(18)F]FDG uptake patterns in the lungs, excluding clinical target volumes, and the interaction with radiation dose. An increase in the dyspnea grade of 1 (Common Terminology Criteria for Adverse Events version 3.0) or more points compared to the pre-RT score was used as an endpoint for analysis of RILT. The effect of [(18)F]FDG and CT-based variables, dose, and other patient or treatment characteristics that effected RILT was studied using logistic regression., Results: Increased lung density and pretreatment [(18)F]FDG uptake were related to RILT after RT with univariable logistic regression. The 95th percentile of the [(18)F]FDG uptake in the lungs remained significant in multivariable logistic regression (p = 0.016; odds ratio [OR] = 4.3), together with age (p = 0.029; OR = 1.06), and a pre-RT dyspnea score of ≥1 (p = 0.005; OR = 0.20). Significant interaction effects were demonstrated among the 80th, 90th, and 95th percentiles and the relative lung volume receiving more than 2 and 5 Gy., Conclusions: The risk of RILT increased with the 95th percentile of the [(18)F]FDG uptake in the lungs, excluding clinical tumor volume (OR = 4.3). The effect became more pronounced as the fraction of the 5%, 10%, and 20% highest standardized uptake value voxels that received more than 2 Gy to 5 Gy increased. Therefore, the risk of RILT may be decreased by applying sophisticated radiotherapy techniques to avoid areas in the lung with high [(18)F]FDG uptake., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Published
2011
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23. The ESTRO Breur Lecture 2009. From population to voxel-based radiotherapy: exploiting intra-tumour and intra-organ heterogeneity for advanced treatment of non-small cell lung cancer.

Author

Lambin P, Petit SF, Aerts HJ, van Elmpt WJ, Oberije CJ, Starmans MH, van Stiphout RG, van Dongen GA, Muylle K, Flamen P, Dekker AL, and De Ruysscher D

Subjects
Carcinoma, Non-Small-Cell Lung diagnostic imaging, Decision Support Techniques, Humans, Lung Neoplasms diagnostic imaging, Radiography, Radiotherapy Dosage, Carcinoma, Non-Small-Cell Lung radiotherapy, Lung Neoplasms radiotherapy
Abstract

Evidence is accumulating that radiotherapy of non-small cell lung cancer patients can be optimized by escalating the tumour dose until the normal tissue tolerances are met. To further improve the therapeutic ratio between tumour control probability and the risk of normal tissue complications, we firstly need to exploit inter patient variation. This variation arises, e.g. from differences in tumour shape and size, lung function and genetic factors. Secondly improvement is achieved by taking into account intra-tumour and intra-organ heterogeneity derived from molecular and functional imaging. Additional radiation dose must be delivered to those parts of the tumour that need it the most, e.g. because of increased radio-resistance or reduced therapeutic drug uptake, and away from regions inside the lung that are most prone to complication. As the delivery of these treatments plans is very sensitive for geometrical uncertainties, probabilistic treatment planning is needed to generate robust treatment plans. The administration of these complicated dose distributions requires a quality assurance procedure that can evaluate the treatment delivery and, if necessary, adapt the treatment plan during radiotherapy., (Copyright 2010 Elsevier Ireland Ltd. All rights reserved.)

Published
2010
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