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Updated: May 18, 2026
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Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition
Published on: March 11, 2021
Dose-volume histogram parameters for predicting radiation pneumonitis using receiver operating characteristic curve
Dongqing Wang1, Jian Shi, Shaohua Liang
1Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, People's Republic of China.
Summary
Dose-volume histogram (DVH) parameters like V(5) and V(20) can predict radiation pneumonitis (RP) in lung cancer patients. However, individual DVH metrics show limited predictive power for RP development.
Area of Science:
- Radiation oncology
- Medical physics
- Pulmonary medicine
Background:
- Radiation pneumonitis (RP) is a common toxicity following thoracic radiotherapy for non-small cell lung cancer (NSCLC).
- Predicting RP risk is crucial for optimizing treatment plans and minimizing patient morbidity.
- Dose-volume histogram (DVH) parameters quantify radiation dose distribution to organs at risk, including the lungs.
Purpose of the Study:
- To evaluate the predictive capability of various DVH parameters for the development of radiation pneumonitis (RP).
- To utilize receiver operating characteristic (ROC) curve analysis to assess the sensitivity, specificity, and predictive values of DVH parameters.
- To identify key DVH metrics that correlate with RP in patients with locally advanced NSCLC.
Main Methods:
- Retrospective analysis of 135 locally advanced NSCLC patients treated with 3D radiotherapy and chemotherapy.
- Endpoint: Grade ≥2 RP, defined by National Cancer Institute Common Terminology Criteria for Adverse Events v3.0.
- ROC curve analysis was employed to determine the predictive performance of DVH parameters, including V(5), V(10), V(13), V(20), and Mean Lung Dose (MLD).
Main Results:
- Several DVH parameters, including V(5), V(10), V(13), V(20), and MLD, were significantly correlated with RP development (p < 0.05).
- V(5) and V(20) emerged as the most significant predictors (p = 0.045 and 0.037, respectively), with odds ratios of 3.166 and 3.030.
- Despite significant correlations, the areas under the ROC curve for V(5) and V(20) were modest (0.643 and 0.648), indicating limited predictive power for individual metrics.
Conclusions:
- V(5) and V(20) demonstrate potential as predictors for radiation pneumonitis in NSCLC patients.
- However, relying on single DVH metrics alone does not provide sufficiently high predictive accuracy for RP.
- Further research may be needed to develop more robust predictive models incorporating multiple DVH parameters or other clinical factors.
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