A prospective study on radiation pneumonitis following conformal radiation therapy in non-small-cell lung cancer: clinical and dosimetric factors analysis

Claude, L.; Pérol, David; Ginestet, C.; Falchero, L.; Arpin, D.; Vincent, Michel; Martel, I.; Hominal, S.; Cordier, Jean-François; Carrié, C.

doi:10.1016/j.radonc.2004.02.005

Cited by 190 publications

(138 citation statements)

References 19 publications

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“…At the same time, it was shown that there is a high correlation of the decrease in the percentage of FEV1 and V20, (r=0.49, P=0.032). Our observations confirm V20 as a significant factor of predisposition for the manifestation of RP in accordance with relevant publications (Claude et al, 2005;Piotrowski et al, 2005;Kong et al, 2006;Uno et al, 2006;Schallenkamp et al, 2007;Ramella et al, 2010;Kimura et al, 2012;Kumar et al, 2012).…”

Section: Discussionsupporting

confidence: 93%

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Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

Kouloulias

Zygogianni²,

Efstathopoulos³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

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Section: Discussionsupporting

confidence: 93%

“…The percentage of the pulmonary parenchyma's volume that was radiated with more than 20 Gy (V20) was correlated with the manifestation of radiation-induced pulmonary injury (Graham et al, 1999;Hernando et al, 2001;Claude et al, 2005). Toxicity increases when V20 is increased and the patients' symptoms become louder (Graham et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

Kouloulias

Zygogianni²,

Efstathopoulos³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Several of these clinical factors, such as gender (8,16,23,(36)(37)(38)(39)(40)(41)(42)(43), age (36)(37)(38)(39)(41)(42)(43)(44)(45)(46) and tobacco use (18,22,(36)(37)(38)45,47), may have an impact on RT-induced lung injury, and are not considered in our analysis. For the analysis of responders vs. non-responders, it is not possible to control for all of the clinical variables (such as rates of patients with SCLC, or early stage lesions) since the phenotype of responders and non-responders may be fundamentally different.…”

Section: Study Limitationsmentioning

confidence: 99%

The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response

Mao

Koçak

Zhou

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To assess the impact of induction chemotherapy, and associated tumor shrinkage, on the subsequent radiation-related changes in pulmonary function and tumor response.Methods and Materials-As part of a prospective IRB-approved study, 91 evaluable patients treated definitively with thoracic RT for unresectable lung cancer were analyzed. The rates of RTassociated pulmonary toxicity and tumor response were compared in the patients with and without pre-RT chemotherapy. In the patients receiving induction chemotherapy, the rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without a response (modified RECIST criteria) to the pre-RT chemotherapy. Comparisons of the rates of improvements in PFTs post-RT, dyspnea requiring steroids, and percent declines in PFTs post-RT were compared in patient subgroups using Fisher's exact test, analysis of variance, and linear or logistic regression.Results and conclusion-The use of pre-RT chemotherapy appears to increase the rate of radiation-induced pneumonitis (p=0.07-0.01), but has no consistent impact on changes in PFTs. The degree of induction-chemotherapy-associated tumor shrinkage is not associated with the rate of subsequent-RT-associated pulmonary toxicity. The degree of tumor response to chemotherapy is not related to the degree of tumor response to RT. Additional study is needed to better clarify this issue.

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“…According to a systematic review (1), clinically significant RP usually develops in 13-37% of patients receiving radical dose radiation therapy for lung cancer. Despite the large number of studies (2)(3)(4)(5)(6)(7)(8)23,24) involving clinical and dosimetric prognostic factors for RP, there are currently no validated and standardized factors for prediction. In clinical practice, the mean lung dose (MLD) and VDth (the volume of lung receiving more than a threshold dose) are the most common parameters used as predictors (2)(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Functional dose-volume histograms for predicting radiation pneumonitis in locally advanced non-small cell lung cancer treated with late-course accelerated hyperfractionated radiotherapy

Dongqing

Wang

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to determine whether functional dose-volume histograms (FDVHs) are valuable for predicting radiation pneumonitis (RP), and to identify whether FDVHs have advantages over conventional dose-volume histograms (DVHs) for the prediction of RP in patients with locally advanced non-small cell lung cancer (LANSCLC). Fifty-seven patients with LANSCLC undergoing functional image-guided late-course accelerated hyperfractionated radiotherapy were enrolled. The grade of RP was evaluated according to the Common Toxicity Criteria 3.0. To identify predictive factors of RP, the FDVHs, including the volume of the functional lung receiving 5 Gy (FV 5 ) through 50 Gy (FV 50 ), mean perfusion-weighted lung dose (MPWLD) and functional normal tissue complication probability (FNTCP), were analyzed and compared to their counterparts [total lung receiving 5 Gy (V 5 ) through 50 Gy (V 50 ), mean lung dose (MLD) and normal tissue complication probability (NTCP)] derived from conventional DVHs. Univariate analysis revealed that V 5 -V 40 , MLD, NTCP and FV 5 -FV 50 , MPWLD, FNTCP were all statistically significant relative to the development of RP (all p<0.05). Multivariate analysis showed that only MLD and FV 15 were associated with RP (p=0.001 and 0.044, respectively). Receiver operator characteristic curve anaysis indicated that almost all of the FDVHs had larger areas under the curve compared to the DVHs, although no statistically significant difference was observed (p-value ranged from 0.066 to 0.951). FDVHs are valuable for predicting RP with the predictive efficiency equivalent to or slightly advantageous over conventional DVHs. More homogeneous studies involving larger numbers of patients are required to further assess the value of FDVHs for predicting RP.

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A prospective study on radiation pneumonitis following conformal radiation therapy in non-small-cell lung cancer: clinical and dosimetric factors analysis

Cited by 190 publications

References 19 publications

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response

Functional dose-volume histograms for predicting radiation pneumonitis in locally advanced non-small cell lung cancer treated with late-course accelerated hyperfractionated radiotherapy

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