Predictive Factors of Radiation-Induced Lung Toxicity in Lung Cancer Patients: A Retrospective Study
Background: Radiation-induced lung toxicity is an important dose-limiting toxicity in lung cancer radiotherapy, for which there are no generally accepted predictive factors. This study seeks to identify risk factors associated with the development of severe radiation-induced lung toxicity using c...
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Format: | Article |
Language: | English |
Published: |
Shiraz University of Medical Sciences
2016-07-01
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Series: | Middle East Journal of Cancer |
Subjects: | |
Online Access: | http://mejc.sums.ac.ir/index.php/mejc/article/view/391/262 |
Summary: | Background: Radiation-induced lung toxicity is an important dose-limiting toxicity
in lung cancer radiotherapy, for which there are no generally accepted predictive
factors. This study seeks to identify risk factors associated with the development of severe
radiation-induced lung toxicity using clinical and dosimetric parameters.
Methods: We reviewed the medical records of 54 patients with histologically
proven stage III non-small cell lung cancer treated with three dimensional-conformal
radiotherapy at Alexandria Main University Hospital between January 2008 and
December 2011. The original treatment plans for those patients were restored and
imported to a treatment planning system. Lung dose–volume histograms and various
dosimetric parameters were calculated. Univariate and multivariate logistic regression
analyses were performed.
Results: The following grades of radiation-induced lung toxicity were observed in
patients - grade 0: 17 (31.5%), grade 1: 5 (9.3%), grade 2: 13 (24.1%), grade 3: 15
(27.8%), and grade 5: 4 (7.4%). A total of 19 (35.2%) patients developed grade ≥3 and
were considered to have an event. Univariate analysis showed that age, presence of
chronic obstructive pulmonary disease and location of the primary tumor had significant
associations with severe radiation-induced lung toxicity. Other dosimetric variables such
as tumor side, histology, forced expiratory volume in 1 s, smoking, and gender showed
no significant correlations with severe radiation-induced lung toxicity. Multivariate
analysis showed that the presence of chronic obstructive pulmonary disease (P=0.001)
and location of the primary tumor (P=0.010) were the only predictive factors for
severe radiation-induced lung toxicity.
Conclusion: This study demonstrates that patients with chronic obstructive
pulmonary disease and lower lung lobe tumors have a high risk of severe radiationinduced
lung toxicity when treated with combined chemoradiotherapy. These easily
obtained clinical factors should be considered when calculating the risk for radiationinduced
lung toxicity. |
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ISSN: | 2008-6709 2008-6687 |