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Predicting Radiotherapy-Induced Bone Injury Following Stereotactic Body Radiotherapy for Lung Cancer

Purpose: To predict the risk of a rib fracture within 25 months of stereotactic body radiotherapy (SBRT) for lung cancer based on the nomogram of Taremi et al.

Description

Taremi et al developed a nomogram for predicting radiotherapy-induced bone injury (RIBI) following stereotactic lung radiotherapy. These can help to identify patients who may benefit from closer monitoring or an alternative therapy. The authors are from Princess Margaret Hospital and University of Toronto.


Patient selection: lung cancer treated with stereotactic body radiotherapy (SBRT), ages 45 to 90 years

 

Outcome: rib fracture within 25 months of SBRT

 

Parameters:

(1) age in years

(2) gender

(3) D 0.5 (dose to 0.5 cc of the ribs in rads)

 

Gender

Points

male

0

female

24.33

 

points for age =

= (1.8533 * (years)) - 83.4

 

points for D 0.5 =

= (0.014286 * (D 0.5))

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score around 204

• The higher the score the greater the risk of a rib fracture.

 

Score

Percent Rib Fracture

< 80

< 1%

80 to 119.4

(0.2284 * (points)) - 17.274

119.4 to 173

(0.007206 * ((points)^2)) - (0.875 * (points)) + 11.19

173 to 203

(-0.009682 * ((points)^2)) + (4.369 * (points)) - 392.5

> 203

> 95%

 


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Specialty

Objective

ICD-10