Validation of Effective Dose as a Better Predictor of Radiation Pneumonitis Risk than Mean Lung Dose: Secondary Analysis of a Randomized Trial

We found that a normal tissue complications model based on effective dose (Deff) (with volume parameter n=0.5, corresponding to root mean squared dose) predicts risk of radiation pneumonitis after either intensity-modulated radiation therapy or passively scattering proton therapy more accurately than a model based on mean lung dose and suggests that delivering higher doses to smaller lung volumes (vs. lower doses to larger volumes) may increase RP risk more than previously recognized.

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