|Table of Contents|

Symptomatic radiation pneumonitis following intensity modulated radiotherapy for stage Ⅲ and Ⅳ non-small cell lung cancer:Dose-volume histogram analysis

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2017 04
Page:
561-565
Research Field:
Publishing date:

Info

Title:
Symptomatic radiation pneumonitis following intensity modulated radiotherapy for stage Ⅲ and Ⅳ non-small cell lung cancer:Dose-volume histogram analysis
Author(s):
Chen Yin1; Wang Xiaoping1; Sun Xiangdong1; Hua Haiqing2; Zhang Xinliang1
1.Department of Radiotherapy；2.Department of Medical Oncology of PLA Cancer Center,the 81st Hospital of PLA Affiliated Nanjing University of Chinese Medicine，Jiangsu Nanjing 210002，China.
Keywords:
non-small cell lung cancer; radiation therapy; radiation pneumonitis; dose-volume histogram
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2017.04.016
Abstract:
Objective:To determine lung dosimetric constraints that correlated with symptomatic radiation pneumonitis( ≥2 grade) in stage Ⅲ and Ⅳ non-small cell lung cancer patients treated with intensity modulated radiotherapy(IMRT).Methods: 53 NSCLC patients were treated with IMRT.Several dosimetric factors and ≥2 grade RP incidence were recorded and analyzed.Radiation induced lung injury was evaluated according to the standard CTCAE4.0.Univariate and multivariate analyses were performed to assess the relationship between dosimetric factors and ≥2 grade RP.The ROC curve was used to explore the predictive sensitivity(SEN) and specificity(SPE) for potential DVH parameters associated with ≥2 grade RP.Results:The morbidity of ≥2 grade RP was 18.87%,and grade of 2,3,and 4 were 9.43%,5.66%,3.77%,respectively.According to Spearman rank correlation analyses,V5,V20,MLD were the prognostic factors associated with RP of grade 2 or greater(r=0.485,0.404,0.404，P=0.000,0.003,0.003).According to univariate analyses,V5,V20,MLD were significantly related to RP of grade 2 or greater（t=-4.588,-2.433,-2.845，P=0.000,0.019,0.006）.According to multivariate analyses,V5 was the only factor associated with RP of grade 2 or greater（P=0.03）.According to ROC curve analyses，V5 was valuable in predicting RP of grade 2 or greater.If predictive cut-off values was established as follows:V5=0.862,the parameters could provide predictive SEN,SPE were 1.00 and 0.442.And RP incidence of grade 2 or greater were 7.14% and 32% in patients with a V5 of ＜43.65% and ≥43.65%,respectively.Conclusion:Dosimetric factors are associated with RP of grade 2 or greater,and the incidence and grade of RP are significantly related to the V5 value.

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Last Update: 2016-12-29