Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis
Abstract Background 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 irrad...
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doaj-0a4d803e34b948c99435c406a3e486022020-11-25T01:44:44ZengBMCBMC Cancer1471-24072019-11-011911810.1186/s12885-019-6359-9Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysisKuniaki Katsui0Takeshi Ogata1Kenta Watanabe2Norihisa Katayama3Junichi Soh4Masahiro Kuroda5Katsuyuki Kiura6Yoshinobu Maeda7Shinichi Toyooka8Susumu Kanazawa9Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceDepartment of Radiology, Iwakuni Clinical CenterDepartment of Radiology, Okayama University HospitalDepartment of Radiology, Okayama University HospitalDivision of Thoracic Surgery, Department of Surgery, Kindai University Faculty of MedicineDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityDepartment of Allergy and Respiratory Medicine, Okayama University HospitalHematology, Oncology and Respiratory MedicineGeneral Thoracic Surgery and Breast and Endocrinological SurgeryRadiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceAbstract Background 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. Methods 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. Results 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. Conclusions 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.http://link.springer.com/article/10.1186/s12885-019-6359-9Radiation pneumonitisMean lung doseLower lobeInduction chemoradiotherapyNon-small cell lung cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kuniaki Katsui Takeshi Ogata Kenta Watanabe Norihisa Katayama Junichi Soh Masahiro Kuroda Katsuyuki Kiura Yoshinobu Maeda Shinichi Toyooka Susumu Kanazawa |
spellingShingle |
Kuniaki Katsui Takeshi Ogata Kenta Watanabe Norihisa Katayama Junichi Soh Masahiro Kuroda Katsuyuki Kiura Yoshinobu Maeda Shinichi Toyooka Susumu Kanazawa Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis BMC Cancer Radiation pneumonitis Mean lung dose Lower lobe Induction chemoradiotherapy Non-small cell lung cancer |
author_facet |
Kuniaki Katsui Takeshi Ogata Kenta Watanabe Norihisa Katayama Junichi Soh Masahiro Kuroda Katsuyuki Kiura Yoshinobu Maeda Shinichi Toyooka Susumu Kanazawa |
author_sort |
Kuniaki Katsui |
title |
Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis |
title_short |
Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis |
title_full |
Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis |
title_fullStr |
Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis |
title_full_unstemmed |
Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis |
title_sort |
dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2019-11-01 |
description |
Abstract Background 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. Methods 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. Results 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. Conclusions 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. |
topic |
Radiation pneumonitis Mean lung dose Lower lobe Induction chemoradiotherapy Non-small cell lung cancer |
url |
http://link.springer.com/article/10.1186/s12885-019-6359-9 |
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