Radiomics analysis of 3D dose distributions to predict toxicity of radiotherapy for lung cancer

Highlights: • The miscalibration of pulmonary and esophageal toxicities in patients with lung cancer treated by (chemo)-radiotherapy is frequent. • Usual dose-volume histograms do not account for dose spatial distribution. • Radiomics based models contribute to a significant improvement in acute and late pulmonary toxicities prediction. For acute esophageal toxicity, dosimetric and radiomics based models achieve similar results. (Chemo)–radiotherapy (RT) is the gold standard treatment for patients with locally advanced lung cancer non accessible for surgery. However, current toxicity prediction models rely on clinical and dose volume histograms (DVHs) and remain unsufficient. The goal of this work is to investigate the added predictive value of the radiomics approach applied to dose maps regarding acute and late toxicities in both the lungs and esophagus.