Dyspnea in Patients Receiving Radical Radiotherapy for Non-Small Cell Lung Cancer: A Prospective Study

Sardaro, Angela; McDonald, Fiona; Bardoscia, Lilia; Lavrenkov, Konstantin; Singh, Shalini; Ashley, S.; Traish, D.; Ferrari, Cristina; Meattini, Icro; Asabella, Artor Niccoli; Brada, Michael

doi:10.3389/fonc.2020.594590

Cited by 8 publications

(5 citation statements)

References 54 publications

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“…As this study focused on lung cancer patients with IP, PT can be considered to be a less invasive treatment. However, the changes in QLQ-LC13 dyspnea scores seen at 3 months after radiotherapy have been shown to be correlated with lung V 30Gy , V 40Gy , V 50Gy , and MLD values [ 52 ]. Previous studies have suggested that a lung V 40Gy cut-off value of 11% exhibits good sensitivity and specificity as a predictor of dyspnea.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of proton therapy for non-small cell lung cancer in patients with interstitial pneumonia

et al. 2022

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Background Interstitial pneumonia (IP) is a disease with a poor prognosis. In addition, IP patients are more likely to develop lung cancer. Since IP patients frequently develop toxicities during cancer treatment, minimally invasive cancer treatment is warranted for such patients to maintain their quality of life. This study retrospectively investigated the efficacy and safety of proton therapy (PT) for non-small cell lung cancer (NSCLC) in patients with IP. Methods Twenty-nine NSCLC patients with IP were treated with PT between September 2013 and December 2019. The patients had stage IA to IIIB primary NSCLC. Ten of the 29 patients exhibited the usual interstitial pneumonia pattern. The prescribed dose was 66–74 Grays (relative biological effectiveness) in 10–37 fractions. Results The median follow-up period was 21.1 months [interquartile range (IQR), 15.6–37.3] for all patients and 37.2 months (IQR, 24.0–49.9) for living patients. The median patient age was 77 years (IQR, 71–81). The median planning target volume was 112.0 ml (IQR, 56.1–246.3). The 2-year local control, progression-free survival, and overall survival rates were 85% (95% confidence interval: 57–95), 30% (15–47), and 45% (26–62), respectively. According to the Common Terminology Criteria for Adverse Events (version 4.0), grade 3 acute radiation pneumonitis (RP) was observed in 1 patient. Two patients developed grade 3 late RP, but no other patients experienced serious toxicities. The patients’ quality of life (European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-LC13 and SF-36) scores had not changed after 3 months. Conclusions PT may be a relatively safe treatment for NSCLC patients with IP, without deteriorating quality of life scores within 3 months.

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Section: Discussionmentioning

confidence: 99%

Outcomes of proton therapy for non-small cell lung cancer in patients with interstitial pneumonia

et al. 2022

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“…In the present analysis, in order to account for different fractionation regimens, the BED-VH metrics were extracted and the V 15Gy|α/β=3 resulted to be an independent dose metric predictor for dyspnea, an important symptomatic endpoint for assessment of RILD [45]. Notably, the use of the adopted BED model is not universally accepted, especially when large fraction sizes are considered.…”

Section: Resultsmentioning

confidence: 99%

Radiation-Induced Dyspnea in Lung Cancer Patients Treated with Stereotactic Body Radiation Therapy

Cella

Monti

Thor

et al. 2021

Cancers

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In this study, we investigated the prognostic factors for radiation-induced dyspnea after hypo-fractionated radiation therapy (RT) in 106 patients treated with Stereotactic Body RT for Non-Small-Cell Lung Cancer (NSCLC). The median prescription dose was 50 Gy (range: 40–54 Gy), delivered in a median of four fractions (range: 3–12). Dyspnea within six months after SBRT was scored according to CTCAE v.4.0. Biologically Effective Dose (α/β = 3 Gy) volume histograms for lungs and heart were extracted. Dosimetric parameters along with patient-specific and treatment-related factors were analyzed, multivariable logistic regression method with Leave-One-Out (LOO) internal validation applied. Model performance was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC) and calibration plot parameters. Fifty-seven patients (53.8%) out of 106 developed dyspnea of any grade after SBRT (25/57 grade ≥ 2 cases). A three-variable predictive model including patient comorbidity (COPD), heart volume and the relative lungs volume receiving more than 15 Gy was selected. The model displays an encouraging performance given by a training ROC-AUC = 0.71 [95%CI 0.61–0.80] and a LOO-ROC-AUC = 0.64 [95%CI 0.53–0.74]. Further modeling efforts are needed for dyspnea prediction in hypo-fractionated treatments in order to identify patients at high risk for developing lung toxicity more accurately.

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Section: Discussionmentioning

confidence: 97%

Outcomes of Proton Therapy for Non-small Cell Lung Cancer in Patients with Interstitial Pneumonia

Hashimoto¹,

Iwata²,

Hattori³

et al. 2021

Preprint

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Background:Interstitial pneumonia (IP) is a disease with a poor prognosis. In addition, IP patients are more likely to develop lung cancer. Since IP patients frequently develop toxicities during cancer treatment, minimally invasive cancer treatment is warranted for such patients to maintain their quality of life. This study retrospectively investigated the efficacy and safety of proton therapy (PT) for non-small cell lung cancer (NSCLC) in patients with IP.Methods:Twenty-nine NSCLC patients with IP were treated with PT between September 2013 and December 2019. The patients had stage IA to IIIB primary NSCLC. Ten of the 29 patients exhibited the usual interstitial pneumonia pattern. The prescribed dose was 66-74 Grays (relative biological effectiveness) in 10-37 fractions.Results:The median follow-up period was 17.4 months (interquartile range (IQR), 9.5–32.7). The median patient age was 77 years (IQR, 71–81). The median planning target volume was 112.0 ml (IQR, 56.1–246.3). The 2-year local control, progression-free survival, and overall survival rates were 77% (95% confidence interval: 34 to 94), 31% (13–50), and 50% (26–70), respectively. According to the Common Terminology Criteria for Adverse Events (version 4.0), grade 3 acute radiation pneumonitis (RP) was observed in 1 patient. Two patients developed grade 3 late RP, but no other patients experienced serious toxicities. The patients’ quality of life (European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-LC13 and SF-36) scores had not changed after 3 months.Conclusions:PT may safely control NSCLC without adversely affecting the daily lives of IP patients.

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Dyspnea in Patients Receiving Radical Radiotherapy for Non-Small Cell Lung Cancer: A Prospective Study

Cited by 8 publications

References 54 publications

Outcomes of proton therapy for non-small cell lung cancer in patients with interstitial pneumonia

Outcomes of proton therapy for non-small cell lung cancer in patients with interstitial pneumonia

Radiation-Induced Dyspnea in Lung Cancer Patients Treated with Stereotactic Body Radiation Therapy

Outcomes of Proton Therapy for Non-small Cell Lung Cancer in Patients with Interstitial Pneumonia

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