Published in the Red Journal, this retrospective analysis by MD Anderson group reviewed 203 patients treated with protons or IMRT to 66-74 Gy(RBE) in 33-37 fractions with concurrent carboplatin/paclitaxel.

By analyzing the 46 experienced grade ≥2 radiation pneumonitis at a median 3.7 months, this study found that the effective dose (Deff) with n=0.5 (corresponding to root mean squared dose) is a better predictor of RP than MLD. Differences between Deff and MLD indicate that delivering higher doses to smaller lung volumes (vs. lower doses to larger volumes) increases RP risk.