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Risk factors of acute radiation pneumonitis in patients with non-small cell lung cancer after concur-rent three-dimensional conformal radiotherapy and chemotherapy

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Author:: No author available

Journal Title:: CHINESE JOURNAL OF RADIATION ONCOLOGY

Issue:: 6

DOI:: 10.3760/cma.j.issn.1004-4221.2009.06.443

Key Word:: 肺肿瘤/放射疗法;放射疗法;三维适形;肺肿瘤/化学疗法;化学疗法;同期;放射性肺炎;因素分析;Lung neoplasms/radiotherapy;Radiotherapy,three-dimensional conformal;Lung neoplasms/chemotherapy;Chemotherapy,concurrent;Radiation pneumonitis;Factor analysis

Abstract： Objective To analyze the incidence and related factors of acute radiation pneumonitis (RP) in patients with non-small cell lung cancer (NSCLC) who underwent three-dimensional conformal ra-diotherapy with concurrent chemotherapy. Methods From January 2006 to October 2008, 90 NSCLC pa-tients treated with concurrent chemoradiotherapy were retrospectively reviewed. The clinical characteristics and treatment plan parameters from dose-volume histogram (DVH) were analyzed. Results Grade 1, 2,3, 4 and 5 RP was found in 32.2%, 30.0%, 5.6%, 0% and 1.1% of the patients. Primary tumor loca-tion was the only significant clinical factor in univariate analysis. And significant differences were found when the groups was divided by the mean lung dose (MLD) of 17 Gy, V_(5) of 47% ,V_(10) of 36% ,V_(20) of 24%,V_(30) of 23% and V_(40) of 22%, respectively. Multivariate analysis showed the MLD was the only independent predictive factor of RP. Conclusions Some factors may contribute to the RP. MLD should be set below 17 Gy in three-dimensional conformal radiation, especially when the tumor locates in the lower lobe.

Reference

[1]王明臣,刘洪明,刘杰,等.放射性肺炎影响因素的多元回归分析[J].2003,(z1).
[2]Wei X,Liu HH,Tucker SL,etc.Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT).[J].2006,66(5).
[3]S L, Kwa,J V, Lebesque,J C, Theuws,etc.Radiation pneumonitis as a function of mean lung dose: an analysis of pooled data of 540 patients.[J].1998,42.
[4]Nosov D,Falchero L,Cordier JF,etc.Early variations of circulating interleukin-6 and interleukin-10 levels during thoracic radiotherapy are predictive for radiation pneumonitis.[J].2005,23(34).
[5]J G, Armstrong,M J, Zelefsky,S A, Leibel,etc.Strategy for dose escalation using 3-dimensional conformal radiation therapy for lung cancer.[J].1995,6.
[6]Kotani Y,Satouchi M,Tsujino K,etc.Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer.[J].2003,55(1).
[7]M. Yamada,S. Kudoh,K. Hirata,etc.Risk factors of pneumonitis following chemoradiotherapy for lung cancer[J].1998,34(1).
[8]Folz RJ,Marks LB,Zhou SM,etc.Challenges in defining radiation pneumonitis in patients with lung cancer.[J].2005,62(3).
[9]Thrasher B,Vujaskovic Z,Rabbani Z,etc.Antitransforming growth factor-beta antibody 1D11 ameliorates normal tissue damage caused by high-dose radiation.[J].2006,65(3).
[10]Robnett TJ,Machtay M,Vines EF,etc.Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer.[J].2000,48(1).
[11]M, Roach,D R, Gandara,H S, Yuo,etc.Radiation pneumonitis following combined modality therapy for lung cancer: analysis of prognostic factors.[J].1995,13(10).
[12]D, Oetzel,P, Schraube,F, Hensley,etc.Estimation of pneumonitis risk in three-dimensional treatment planning using dose-volume histogram analysis.[J].1995,33.
[13]Perez CA,Lockett MA,Bosch W,etc.Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC).[J].1999,45(2).
[14]Y, Segawa,N, Takigawa,M, Kataoka,etc.Risk factors for development of radiation pneumonitis following radiation therapy with or without chemotherapy for lung cancer.[J].1997,39.
[15]Merrick S,Venkatraman E,Burman C,etc.Dose-volume factors contributing to the incidence of radiation pneumonitis in non-small-cell lung cancer patients treated with three-dimensional conformal radiation therapy.[J].2002,54(2).
[16]R.W Byhardt,C Scott,W.T Sause,etc.Response, toxicity, failure patterns, and survival in five radiation therapy oncology group (RTOG) trials of sequential and/or concurrent chemotherapy and radiotherapy for locally advanced non-small-cell carcinoma of the lung[J].1998,42(3).
[17]Schipper MJ,Kong FM,Chen M,etc.High-dose radiation improved local tumor control and overall survival in patients with inoperable/unresectable non-small-cell lung cancer: Long-term results of a radiation dose escalation study.[J].2005,63(2).
[18]Jedidiah M. Monson M.D., M.P.H.,Paul Stark M.D.,John J. Reilly M.D.,etc.Clinical radiation pneumonitis and radiographic changes after thoracic radiation therapy for lung carcinoma[J].1998,82(5).
[19]Kong FM,Hayman JA,Griffith KA,etc.Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (NSCLC): predictors for radiation pneumonitis and fibrosis.[J].2006,65(4).
[20]Fay M,Fisher R,Mac Manus M,etc.Dose-volume histogram analysis as predictor of radiation pneumonitis in primary lung cancer patients treated with radiotherapy.[J].2005,61(5).
[21]Vicic M,Hope AJ,Deasy JO,etc.Modeling radiation pneumonitis risk with clinical, dosimetric, and spatial parameters.[J].2006,65(1).
[22]Falchero L,Hominal S,Claude L,etc.A prospective study on radiation pneumonitis following conformal radiation therapy in non-small-cell lung cancer: clinical and dosimetric factors analysis.[J].2004,71(2).
[23]Pommier P,Falchero L,Boutry D,etc.Prospective evaluation of early lung toxicity following three-dimensional conformal radiation therapy in non-small-cell lung cancer: preliminary results.[J].2000,48(2).
[24]C S, Ross,D H, Hussey,E C, Pennington,etc.Analysis of movement of intrathoracic neoplasms using ultrafast computerized tomography.[J].1990,18.
[25]殷蔚伯.肿瘤放射治疗学（第四版） [M].1900.
[26]Rodrigues G,Lock M,D'Souza D,etc.Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer-a systematic review.[J].2004,71(2).
[27]Rancati T,Ceresoli GL,Gagliardi G,etc.Factors predicting radiation pneumonitis in lung cancer patients: a retrospective study.[J].2003,67(3).
[28]Rengan R,Venkatraman E,Nayak R,etc.Improved local control with higher doses of radiation in large-volume stage III non-small-cell lung cancer.[J].2004,60(3).
[29]J D, Cox,J, Stetz,T F, Pajak.Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)[J].1995,31.