Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT

Abstract Background The PEGASUS trial was the first study to evaluate and demonstrate the benefits of 68Ga-perfusion PET/CT in the lung stereotactic body radiotherapy (SBRT) planning process in preserving functional lung volumes while respecting target volume coverage and doses to other organs at ri...

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Main Authors: François Lucia, Jacques Lamour, Margaux Geier, Vincent Bourbonne, Fanny Pinot, Malik Nebbache, Frédérique Blanc-Béguin, Simon Hennebicq, Maëlle Mauguen, Kevin Kerleguer, Ulrike Schick, Olivier Pradier, Grégoire Le Gal, Pierre-Yves Salaun, David Bourhis, Pierre-Yves Le Roux
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Radiation Oncology
Online Access:https://doi.org/10.1186/s13014-025-02685-w
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author François Lucia
Jacques Lamour
Margaux Geier
Vincent Bourbonne
Fanny Pinot
Malik Nebbache
Frédérique Blanc-Béguin
Simon Hennebicq
Maëlle Mauguen
Kevin Kerleguer
Ulrike Schick
Olivier Pradier
Grégoire Le Gal
Pierre-Yves Salaun
David Bourhis
Pierre-Yves Le Roux
author_facet François Lucia
Jacques Lamour
Margaux Geier
Vincent Bourbonne
Fanny Pinot
Malik Nebbache
Frédérique Blanc-Béguin
Simon Hennebicq
Maëlle Mauguen
Kevin Kerleguer
Ulrike Schick
Olivier Pradier
Grégoire Le Gal
Pierre-Yves Salaun
David Bourhis
Pierre-Yves Le Roux
author_sort François Lucia
collection DOAJ
description Abstract Background The PEGASUS trial was the first study to evaluate and demonstrate the benefits of 68Ga-perfusion PET/CT in the lung stereotactic body radiotherapy (SBRT) planning process in preserving functional lung volumes while respecting target volume coverage and doses to other organs at risk. Here we report the prespecified exploratory endpoint of SBRT on health-related quality of life (HRQoL). Methods In this single-center prospective study, we recruited patients planned to be treated in our radiotherapy department with SBRT for primary or secondary lung tumors. Patient-reported outcomes were assessed at the first visit, 1 month, 3 months and every 3 months until 12 months after SBRT using the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 items (QLQ-C30), the EORTC Quality of Life Questionnaire Lung Cancer 13 items (QLQ-LC13), and the European Quality of Life 5 Dimensions-5 Level (EQ-5D-5 L) questionnaire. The key exploratory HRQoL endpoints (analyzed for all patients who completed at least QLQ-C30 at least one time point after SBRT) were baseline-to-early change (between 1 month and 3 month) and baseline-to-late change (between 6 month and 12 month) in the QLQ-C30 global health status (GHS)/quality-of-life (QoL) score and in the deterioration of the dyspnea (patient-reported lung toxicity). Explorative analysis of the impact of baseline HRQoL, patient- and SBRT-related characteristics, including PET perfusion-based functional parameters, on the change in HRQoL from baseline was analyzed using univariate analysis. Results Of the 60 patients included, 39 were analyzable as early-onset and 22 as late-onset. Thirteen (33%) and 7 (32%) patients had a deterioration of QoL. In univariate analysis, maximal dose to the heart, doses to the functional lung volume and pulmonary functional test parameters were significantly associated with the early deterioration of HRQoL. Only doses to the functional lung volume were significantly associated with the late deterioration of HRQoL. Conclusion In our study, increased radiation doses in functional lung volume PET bases dose parameters were significantly associated with a decrease of HRQoL unlike anatomic lung parameters. Functional lung avoidance planning guided by perfusion PET/CT may be a simple and noninvasive method to improve HRQoL in patients treated with lung SBRT.
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series Radiation Oncology
spelling doaj-art-e8aefcda07a8488dbeb62ddca0c9eb042025-08-20T03:46:12ZengBMCRadiation Oncology1748-717X2025-07-0120112010.1186/s13014-025-02685-wPrediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CTFrançois Lucia0Jacques Lamour1Margaux Geier2Vincent Bourbonne3Fanny Pinot4Malik Nebbache5Frédérique Blanc-Béguin6Simon Hennebicq7Maëlle Mauguen8Kevin Kerleguer9Ulrike Schick10Olivier Pradier11Grégoire Le Gal12Pierre-Yves Salaun13David Bourhis14Pierre-Yves Le Roux15Radiation Oncology Department, University HospitalLaTIM INSERM, UMR 1101, University of BrestMedical Oncology Department, University HospitalRadiation Oncology Department, University HospitalGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleLaTIM INSERM, UMR 1101, University of BrestGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleRadiation Oncology Department, University HospitalGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleRadiation Oncology Department, University HospitalRadiation Oncology Department, University HospitalDirection de la Recherche Clinique et de l’Innovation (DRCI), CHU BrestGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleGETBO, INSERM, UMR1304, Université de Bretagne OccidentaleAbstract Background The PEGASUS trial was the first study to evaluate and demonstrate the benefits of 68Ga-perfusion PET/CT in the lung stereotactic body radiotherapy (SBRT) planning process in preserving functional lung volumes while respecting target volume coverage and doses to other organs at risk. Here we report the prespecified exploratory endpoint of SBRT on health-related quality of life (HRQoL). Methods In this single-center prospective study, we recruited patients planned to be treated in our radiotherapy department with SBRT for primary or secondary lung tumors. Patient-reported outcomes were assessed at the first visit, 1 month, 3 months and every 3 months until 12 months after SBRT using the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 items (QLQ-C30), the EORTC Quality of Life Questionnaire Lung Cancer 13 items (QLQ-LC13), and the European Quality of Life 5 Dimensions-5 Level (EQ-5D-5 L) questionnaire. The key exploratory HRQoL endpoints (analyzed for all patients who completed at least QLQ-C30 at least one time point after SBRT) were baseline-to-early change (between 1 month and 3 month) and baseline-to-late change (between 6 month and 12 month) in the QLQ-C30 global health status (GHS)/quality-of-life (QoL) score and in the deterioration of the dyspnea (patient-reported lung toxicity). Explorative analysis of the impact of baseline HRQoL, patient- and SBRT-related characteristics, including PET perfusion-based functional parameters, on the change in HRQoL from baseline was analyzed using univariate analysis. Results Of the 60 patients included, 39 were analyzable as early-onset and 22 as late-onset. Thirteen (33%) and 7 (32%) patients had a deterioration of QoL. In univariate analysis, maximal dose to the heart, doses to the functional lung volume and pulmonary functional test parameters were significantly associated with the early deterioration of HRQoL. Only doses to the functional lung volume were significantly associated with the late deterioration of HRQoL. Conclusion In our study, increased radiation doses in functional lung volume PET bases dose parameters were significantly associated with a decrease of HRQoL unlike anatomic lung parameters. Functional lung avoidance planning guided by perfusion PET/CT may be a simple and noninvasive method to improve HRQoL in patients treated with lung SBRT.https://doi.org/10.1186/s13014-025-02685-w
spellingShingle François Lucia
Jacques Lamour
Margaux Geier
Vincent Bourbonne
Fanny Pinot
Malik Nebbache
Frédérique Blanc-Béguin
Simon Hennebicq
Maëlle Mauguen
Kevin Kerleguer
Ulrike Schick
Olivier Pradier
Grégoire Le Gal
Pierre-Yves Salaun
David Bourhis
Pierre-Yves Le Roux
Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT
Radiation Oncology
title Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT
title_full Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT
title_fullStr Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT
title_full_unstemmed Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT
title_short Prediction of health-related quality-of-life results after lung stereotactic body radiotherapy using dose-volume parameters from functional mapping on Gallium-68 perfusion PET/CT
title_sort prediction of health related quality of life results after lung stereotactic body radiotherapy using dose volume parameters from functional mapping on gallium 68 perfusion pet ct
url https://doi.org/10.1186/s13014-025-02685-w
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