Using 4DCT Lung Ventilation Imaging to Optimize Radiotherapy for Lung Cancer
NCT ID: NCT07312682
Last Updated: 2025-12-31
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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ACTIVE_NOT_RECRUITING
202 participants
OBSERVATIONAL
2024-12-09
2026-11-30
Brief Summary
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Ventilation maps generated from planning 4DCT are used to identify well-ventilated lung regions, enabling paired comparison between functional lung avoidance radiotherapy plans and conventional anatomic radiotherapy plans.
The study aims to assess whether incorporating functional lung information into radiotherapy planning can reduce radiation exposure to well-ventilated lung while maintaining adequate tumor coverage, and to explore its relationship with radiation-induced lung injury.
All analyses are based on existing clinical imaging, treatment planning data, and follow-up records. No additional interventions, imaging, or procedures are performed as part of this study.
Detailed Description
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High-quality 4DCT datasets acquired during routine simulation are processed to generate voxel-based lung ventilation maps using deformable image registration and Jacobian-based computational methods. These ventilation maps are spatially registered to planning CT images and incorporated into the treatment planning system to delineate high-function lung subregions.
For each eligible patient, paired radiotherapy plans are retrospectively generated and analyzed: a conventional anatomic radiotherapy plan and a functional lung avoidance radiotherapy (FLAR) plan that incorporates ventilation-defined avoidance structures. Both plans are optimized to achieve comparable target coverage while differing in lung avoidance strategy.
Dosimetric and clinical data are obtained from existing treatment planning records and routine clinical follow-up to support comparative analyses of functional lung sparing and associated pulmonary outcomes. All analyses are conducted retrospectively using data derived from standard clinical care. No prospective enrollment, additional imaging, or study-specific interventions are performed.
Conditions
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Keywords
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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4DCT-IMRT Lung Cancer Cohort
Single-center retrospective cohort of consecutive lung cancer patients with high-quality 4DCT planned with IMRT (2022-01-01-2025-09-09; actual enrollment = 202). 4DCT-based ventilation maps delineate high-function lung. Paired-plan comparison of functional-lung-avoidance versus conventional plans; primary outcomes: dose to high-function lung and radiation pneumonitis. Secondary outcomes: doses to heart, spinal cord, and esophagus, and plan-quality metrics (e.g., MLD, V20, DVH). No additional procedures or treatments.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* High-quality 4DCT scans performed before radiotherapy, enabling generation of ventilation or perfusion maps.
* Radiotherapy plans designed using IMRT.
* Availability of both functional lung avoidance plans and conventional anatomical radiotherapy plans for paired analysis.
* Complete treatment and follow-up records, including radiation-induced lung injury (e.g., radiation pneumonitis) and pulmonary function tests.
Exclusion Criteria
* Radiotherapy interrupted or incomplete for any reason.
* Severe underlying lung diseases (e.g., extensive emphysema, pulmonary fibrosis, active tuberculosis) that may confound treatment outcomes or toxicity assessment.
* Presence of other untreated primary malignancies during the study period.
* Prior lung surgery or local therapies (e.g., ablation) that may affect evaluation of radiation-induced lung injury.
* Missing follow-up data, making assessment of radiation-induced lung injury or long-term lung function changes impossible.
18 Years
85 Years
ALL
No
Sponsors
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The Second Affiliated Hospital of Chongqing Medical University
OTHER
Responsible Party
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ZhenZhou Yang
Professor of Radiation Oncology, Cancer Center, Second Affiliated Hospital of Chongqing Medical University
Locations
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Cancer Center, Second Affiliated Hospital of Chongqing Medical University
Chongqing, , China
Countries
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References
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Mattila S, Sovijarvi AR, Harjula A, Viljanen A, Takkunen O, Takkunen H, Mattila I, Mattila P, Merikallio E. Effects of mitral valve replacement on ventilation, volumes, diffusing capacity and regional perfusion of lungs in patients with mitral valve disease. Ann Chir Gynaecol. 1985;74(2):82-5.
Henshaw SK. Induced abortion: a world review, 1990. Fam Plann Perspect. 1990 Mar-Apr;22(2):76-89.
Lombardo J, Castillo E, Castillo R, Miller R, Jones B, Miften M, Kavanagh B, Dicker A, Boyle C, Leiby B, Banks J, Simone NL, Movsas B, Grills I, Guerrero T, Rusthoven CG, Vinogradskiy Y. Prospective Trial of Functional Lung Avoidance Radiation Therapy for Lung Cancer: Quality of Life Report. Int J Radiat Oncol Biol Phys. 2024 Oct 1;120(2):593-602. doi: 10.1016/j.ijrobp.2024.03.046. Epub 2024 Apr 12.
Related Links
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National Clinical Research Registration and Filing Information System (China) record for this study(ID：MR-50-25-001899).
Other Identifiers
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IRB-2024-394
Identifier Type: -
Identifier Source: org_study_id