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Updated: May 13, 2026
08:17
Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
Published on: June 7, 2015
Aortic dose constraints when reirradiating thoracic tumors.
Jaden D Evans1, Daniel R Gomez, Arya Amini
1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
Summary
Reirradiation of lung tumors poses risks to the aorta. Doses of 120.0 Gy or higher to 1 cm³ of the aorta were linked to severe (grade 5) aortic toxicity in patients undergoing retreatment.
Area of Science:
- Radiation Oncology
- Medical Physics
- Cardiovascular Science
Background:
- Advances in radiation delivery enable retreatment of thoracic tumors.
- Understanding dose limits for organs at risk is crucial for safe reirradiation.
- The aorta's tolerance to reirradiation after lung tumor treatment is not well-defined.
Purpose of the Study:
- To investigate the dose limits of the aorta associated with grade 5 (fatal) aortic toxicity.
- To determine the maximum cumulative dose to the aorta during reirradiation of lung tumors.
Main Methods:
- Retrospective analysis of 35 patients treated between 1993 and 2008.
- Aorta included in radiation fields for both initial and reirradiation plans.
- Calculation of maximum cumulative dose to 1 cm³ of aorta, normalized and corrected for recovery (NIDR).
Main Results:
- Median follow-up was 42 months; median interval between treatments was 30 months.
- Two of 35 patients (6%) experienced grade 5 aortic toxicity.
- A 25% rate of grade 5 toxicity was observed with composite doses ≥120.0 Gy, versus 0% for doses <120.0 Gy (P=0.047).
Conclusions:
- Grade 5 aortic toxicities were observed with composite doses ≥120.0 Gy (NIDR ≥90.0 Gy) to 1 cm³ of the aorta.
- This finding establishes a potential dose threshold for severe aortic injury in lung tumor reirradiation.
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