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Table 3 Comparison of regarding target volume and organs at risk including heart substructures between original plans (n = 27) and active heart sparing plans (n = 27) in the same patient cohort

From: Development of heart-sparing VMAT radiotherapy technique incorporating heart substructures for advanced NSCLC patients

Structure

Parameter

Original plan

Heart sparing plan

p value

Median

Minimum

Maximum

Median

Minimum

Maximum

PTV

Volume (cc)

252,504

21,016

867,275

252,504

20,936

867,274

0.2558

 

D2 (%)

68,951

67,595

70,161

68,720

61,986

70,154

0.0385

 

D98 (%)

61,879

8,959

64,691

62,730

8,146

64,382

0.2584

Heart

D mean (Gy)

8,177

1,733

21,466

6,707

1,542

11,554

0.0000

 

V5 Gy (%)

40,565

5,346

94,596

27,704

1,474

71,341

0.0000

 

V30 Gy (%)

5,390

0,000

23,840

3,861

0,000

11,514

0.0000

 

V35 Gy (%)

3,883

0,000

20,869

3,369

0,000

10,663

0.0000

 

V50 Gy (%)

1,671

0,000

10,529

1,438

0,000

8,119

0.0037

Heart base

D max (Gy)

38,205

11,249

69,306

16,352

4,592

66,772

0.0000

 

D mean (Gy)

16,966

2,921

32,424

6,355

2,481

10,267

0.0000

 

D max 1 cc (Gy)

27,650

9,325

60,622

8,870

4,080

42,444

0.0000

Ascending aorta

D max 0.03 cc (Gy)

41,659

20,889

68,149

28,789

6,839

69,559

0.0000

 

D max 1 cc (Gy)

37,054

17,807

67,022

23,872

5,581

66,802

0.0000

 

D mean (Gy)

15,781

5,799

42,634

9,875

2,523

29,158

0.0000

Discending aorta

D max 0.03 cc (Gy)

68,891

30,383

70,859

67,719

43,129

71,249

0.2584

 

D max 1 cc (Gy)

67,250

25,720

70,155

66,831

37,909

69,959

0.4846

 

D mean (Gy)

22,238

4,969

46,705

23,929

6,618

43,641

0.0692

LAD

D max (Gy)

18,642

4,113

56,238

6,054

1,822

16,494

0.0000

 

D max 1 cc (Gy)

9,772

1,650

47,053

3,699

1,113

8,023

0.0000

 

D mean (Gy)

7,794

1,201

34,257

3,031

0,942

6,264

0.0000

 

V30 Gy (%)

0,000

0,000

63,095

0,000

0,000

0,000

0.0078

 

V15 Gy (%)

11,111

0,000

91,667

0,000

0,000

2,439

0.0000

Pulmonary artery

D max 0.03 cc (Gy)

68,899

65,433

71,379

68,379

61,224

71,319

0.1399

 

D max 1 cc (Gy)

67,466

46,200

69,551

67,288

40,990

69,846

0.0552

 

D mean (Gy)

35,428

16,134

51,099

25,535

8,348

42,331

0.0000

Superior vena cava

D max 0.03 cc (Gy)

42,888

8,769

68,379

32,053

4,279

69,370

0.5460

 

D max 1 cc (Gy)

29,661

6,860

66,956

27,100

2,761

68,216

0.4270

 

D mean (Gy)

26,040

5,390

65,847

22,859

2,488

66,409

0.0410

Left atrium

D max 0.03 cc (Gy)

67,339

12,599

70,999

61,578

6,009

69,919

0.0762

 

D max 1 cc (Gy)

51,730

10,077

68,550

53,410

5,083

68,409

0.0619

 

D mean (Gy)

14,617

2,178

40,115

11,559

2,216

28,905

0.0013

Right atrium

D max 0.03 cc (Gy)

19,099

1,609

71,119

13,999

1,729

68,979

0.0123

 

D max 1 cc (Gy)

10,448

1,458

68,305

12,294

1,570

67,736

0.0229

 

D mean (Gy)

4,020

0,807

33,310

3,841

0,843

27,352

0.0076

Left ventricle

D max 0.03 cc (Gy)

13,169

2,619

70,509

7,283

1,719

69,899

0.0001

 

D max 1 cc (Gy)

9,530

2,353

68,875

5,632

1,450

66,470

0.0000

 

D mean (Gy)

2,649

0,846

25,066

1,918

0,631

9,143

0.0000

 

V5Gy (%)

9,547

0,000

99,984

0,938

0,000

72,920

0.0000

 

V23 Gy (%)

0,000

0,000

45,679

0,000

0,000

6,565

0.0020

Right ventricle

D max 0.03 cc (Gy)

13,579

1,863

44,259

6,649

1,716

15,319

0.0001

 

D max 1 cc (Gy)

11,150

1,653

37,038

4,869

1,365

11,463

0.0000

 

D mean (Gy)

2,575

0,620

13,445

1,530

0,468

4,790

0.0000

Lungs

MLD (Gy)

13,523

5,067

21,254

13,948

5,108

21,985

0.0000

 

V5 Gy (%)

61,922

25,759

90,333

56,284

26,216

87,351

0.6790

 

V20 Gy (%)

21,675

6,508

36,252

25,529

6,581

38,368

0.0000

 

V30 Gy (%)

11,639

2,542

28,380

16,046

2,441

27,239

0.0000

Esophagus

D mean (Gy)

17,951

2,713

33,283

18,908

4,226

30,202

0.0121

 

D max (Gy)

66,327

23,511

70,914

65,996

25,809

70,061

0.8408

 

V55 Gy (%)

7,570

0,000

41,040

12,386

0,000

35,282

0.0317

 

V60 Gy (%)

3,314

0,000

35,841

3,479

0,000

31,211

0.2063

 

Volume included in 105% isodose (cc) of prescribed dose

0,000

0,000

0,277

0,000

0,000

0,103

0.1250

  1. PTV: planning target volume; GTV: gross tumor volume, SD, standard deviation, LAD: left anterior discending coronary artery; D mean: Mean dose; D max: maximal dose; MLD: mean lung dose; cc: cubic centimeter
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Radiation Oncology

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