Keywords:
CANCER
;
IRRADIATION
;
radiotherapy
;
tumor
;
CELL
;
Germany
;
LUNG
;
THERAPY
;
TOXICITY
;
lung cancer
;
LUNG-CANCER
;
COHORT
;
DISEASE
;
HISTORY
;
RISK
;
radiation
;
ASSOCIATION
;
CONFORMAL RADIOTHERAPY
;
AGE
;
smoking
;
chemotherapy
;
LOCALIZATION
;
PREDICTION
;
ESCALATION
;
ONCOLOGY
;
small cell lung cancer
;
REGRESSION
;
development
;
NSCLC
;
RADIATION PNEUMONITIS
;
MODALITY
;
CONCURRENT CHEMOTHERAPY
;
Dose-volume constraints
Abstract:
Purpose: To analyze the association of patient- and treatment-related factors with the onset of radiation pneumonitis in a homogeneously treated cohort of patients suffering from small cell Lung cancer (SCLC). Patients and Methods: 242 patients with SCLC staged as limited disease, who had been treated with chemotherapy and three-dimensional conformal radiotherapy, were retrospectively analyzed. Pneumonitis was defined by typical symptoms and radiographic findings and judged clinically relevant, if drug administration and hospitalization were necessary. Patient- (age, gender, smoking history, performance status, tumor Localization, benign lung disease) and treatment-related parameters (V-10-V-40, mean lung dose [MLD]) were analyzed using chi(2)-tests for categorical parameters and Logistic regression for continuous variables. Results: 33 patients (13.6%) developed a clinically relevant pneumonitis, of whom three patients died. ALL cases of pneumonitis developed within 120 days. None of the patient-related parameters correlated significantly with the onset of pneumonitis. Considering treatment-related parameters, a significant correlation of V-30 in regard to total lung and V-40 in regard to ipsilateral, contralateral and total Lung to the risk of pneumonitis was found. So, the estimated risk of a clinically relevant pneumonitis increased from 10% given a V-30 of 13% to 30% given a V-30 of 35%. In contrast, no significant correlation was found for V-10 and V-20 and only a trend for MLD. Conclusion: In this series, high-dose radiation volume parameters, i.e., V-30 and especially V-40, were identified as the most important factors for the development of radiation pneumonitis. Low-dose radiation volume parameters and clinical parameters played an inferior role in predicting the pneumonitis risk
Type of Publication:
Journal article published
Deep Link:
http://www.dkfz.de/cgi-bin/sel?http://www.dkfz.de/PublicationManager/Show/ShowJournal.aspx%3fpublishedId=12613
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