A review on functional lung avoidance radiotherapy plan for lung cancer

Area of Science:

• Oncology
• Radiotherapy
• Medical Imaging

Background:

• Lung cancer is a leading cause of cancer-related mortality in China, with radiotherapy (RT) being a critical treatment modality.
• Radiation-induced lung injury (RILI) is a significant dose-limiting toxicity that hinders dose escalation in lung cancer RT.
• Conventional RT planning often overlooks the non-uniformity of lung function, potentially leading to suboptimal outcomes.

Purpose of the Study:

• To review lung function imaging techniques for lung cancer RT planning.
• To explore the clinical applications of function-guided RT, including functional lung avoidance RT (FLART).
• To identify current challenges and future research directions in function-guided RT for lung cancer.

Main Methods:

• Review of lung function imaging modalities relevant to RT planning.
• Discussion of functional lung avoidance RT (FLART) principles and dose-function histogram (DFH) concepts.
• Analysis of clinical data and outcomes from function-guided RT studies.

Main Results:

• FLART aims to reduce radiation exposure to functional lung (FL) tissue, thereby mitigating RILI.
• Dose-function histogram (DFH) provides a framework for optimizing RT plans based on lung function.
• Function-guided RT demonstrates potential for improved therapeutic ratios in lung cancer treatment.

Conclusions:

• Lung function imaging is crucial for personalized lung cancer RT planning.
• FLART offers a promising strategy to minimize RILI by accounting for lung function heterogeneity.
• Further research is needed to refine function-guided RT techniques and clinical implementation.