BMCC19_1_1144.pdf 623 KB
Katsui, Kuniaki Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science ORCID Kaken ID
Ogata, Takeshi Department of Radiology, Iwakuni Clinical Center
Watanabe, Kenta Department of Radiology, Okayama University Hospital
Katayama, Norihisa Department of Radiology, Okayama University Hospital
Soh, Junichi Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine
Kuroda, Masahiro Department of Radiological Technology, Graduate School of Health Sciences, Okayama University
Kiura, Katsuyuki Department of Allergy and Respiratory Medicine, Okayama University Hospital Kaken ID
Maeda, Yoshinobu Hematology, Oncology and Respiratory Medicine
Toyooka, Shinichi Department of General Thoracic Surgery and Breast and Endocrinological SurgeryOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kaken ID
Kanazawa, Susumu Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Kaken ID
The relationship between lung dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) associated with induction concurrent chemoradiotherapy (CCRT) followed by surgery in patients with non-small cell lung cancer (NSCLC) is unclear, particularly when concerning irradiation of the whole lung prior to resection. We performed this study to identify factors associated with grade ≥ 2 RP in such patients.
Patients who received induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 46 Gy/23 fractions) between May 2003 and May 2017 were reviewed. The mean lung dose (MLD) and the percentage of the lung volume that received ≥5 Gy (V5) and ≥ 20 Gy (V20) were calculated. Factors associated with the development of grade ≥ 2 RP were analyzed.
One hundred and eight patients were included in this study, 34 (31.5%) of whom experienced grade ≥ 2 RP. A V20 ≥ 21%, an MLD ≥10 Gy, and a lower lobe tumor location were significant predictors of grade ≥ 2 RP on univariate analysis (p = 0.007, 0.002, and 0.004, respectively). Moreover, an MLD ≥10 Gy and lower lobe location were significant predictors of grade ≥ 2 RP on multivariate analysis (p = 0.026 and 0.0043, respectively). The cumulative incidence rates of grade ≥ 2 RP at 6 months were 15.7 and 45.6% in patients with MLDs < 10 Gy and ≥ 10 Gy, respectively, and were 23.5 and 55.6% in patients with upper/middle lobe- vs. lower lobe-located tumors, respectively.
MLD and lower lobe location were predictors of grade ≥ 2 RP in patients who received induction CCRT. It is necessary to reduce the MLD to the greatest extent possible to prevent the occurrence of this adverse event.
Mean lung dose
Non-small cell lung cancer
© The Author(s). 2019
|Web of Science KeyUT|
Katsui, K., Ogata, T., Watanabe, K. et al. Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis. BMC Cancer 19, 1144 (2019) doi:10.1186/s12885-019-6359-9