Early Graphical Appearance of Radiation Pneumonitis Correlates With the Severity of Radiation Pneumonitis After Stereotactic Body Radiotherapy (SBRT) in Patients With Lung Tumors

Takeda, Atsuya; Ohashi, Toshio; Kunieda, Etsuo; Enomoto, Tatsuji; Sanuki, Naoko; Takeda, Toshiaki; Shigematsu, Naoyuki

doi:10.1016/j.ijrobp.2009.06.001

Cited by 52 publications

(42 citation statements)

References 27 publications

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“…We found a discrepancy in the significant clinical and dosimetric factors between the results of these five studies on low-grade RP [2-6] and our study on severe RP [1]. We speculated that the mechanism underlying the development of grade $3 RP might be different from that of grade 2 RP.…”

contrasting

confidence: 74%

“…The patients' backgrounds were described in the previous report [1] (Table 1). There were 111 primary lung cancers and 22 metastatic lung tumours.…”

Section: Methodsmentioning

confidence: 99%

“…Further studies are needed to identify the mechanism underlying the development of grade 3 RP after SBRT for lung tumours. Previously, we investigated the clinical and dosimetric factors that correlate with severe radiation pneumonitis (RP) in patients with lung tumours treated with stereotactic body radiotherapy (SBRT) [1]. We found that, among a variety of factors, only a short latent period was a significant correlate of severe RP.…”

mentioning

confidence: 99%

“…Most patients with grade $3 RP needed to be admitted to hospital and steroids or oxygen therapy were administered. By contrast, patients with grade 2 RP were simply followed up carefully without administration of medication as outpatients.In the present study, to ascertain this discrepancy, we analysed the clinical and dosimetric factors that correlated with RP after SBRT among patients with grade 0-1, grade 2 and grade 3 RP in the same sample of patients as that included in our previous study [1]. …”

mentioning

confidence: 99%

“…In the present study, to ascertain this discrepancy, we analysed the clinical and dosimetric factors that correlated with RP after SBRT among patients with grade 0-1, grade 2 and grade 3 RP in the same sample of patients as that included in our previous study [1].…”

mentioning

confidence: 99%

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Comparison of clinical, tumour-related and dosimetric factors in grade 0–1, grade 2 and grade 3 radiation pneumonitis after stereotactic body radiotherapy for lung tumours

Takeda

Ohashi²,

Kunieda

et al. 2012

BJR

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Objective: The aim of this study was to investigate significant clinical, tumour-related and dosimetric factors among patients with grade 0-1, grade 2 and grade 3 radiation pneumonitis (RP) after stereotactic body radiotherapy (SBRT) for lung tumours. Methods: Patients (n5128) with a total of 133 lung tumours treated with SBRT of 50 Gy in 5 fractions were analysed. RP was graded according to the Common Terminology Criteria for Adverse Events v.3.0. Significant factors were identified by univariate and multivariate analyses. Threshold dose-volume histograms (DVHs) were constructed to identify the incidence of RP. Results: The median follow-up period was 12 months (range, 6-45 months). In univariate analyses, gender, operability, forced expiratory volume in 1 s (FEV1), internal target volume, lung volumes treated with doses .5-30 Gy (V5-30) and mean lung dose were significant factors differentiating between grade 0-1 and grade 2 RP, and V15-30 were significant factors differentiating between grade 2 and grade 3. However, no factors were significant between grade 0-1 and grade 3 RP. Multivariate analysis showed that female gender, high FEV1 and high V15 were significant factors differentiating between grade 0-1 and grade 2 RP. Threshold DVH curves were created based on #5% and #15% risk of grade 2 RP among patients with grade 0-2 RP. Conclusions: Grade 0-2 RP was dose-volume dependent, and female gender and high FEV1 were significant predictive clinical factors for grade 2 RP among patients with grade 0-2 RP. However, incidences of V15-30 in grade 3 RP were significantly lower than those in grade 2 RP, and no significant clinical or tumour-related factors were found. Further studies are needed to identify the mechanism underlying the development of grade 3 RP after SBRT for lung tumours. Previously, we investigated the clinical and dosimetric factors that correlate with severe radiation pneumonitis (RP) in patients with lung tumours treated with stereotactic body radiotherapy (SBRT) [1]. We found that, among a variety of factors, only a short latent period was a significant correlate of severe RP.Other reports [2][3][4][5][6] have also analysed the clinical and dosimetric factors correlated with RP after SBRT. Various dosimetric factors were reported to significantly correlate with RP after SBRT, which included the mean dose in the ipsilateral lung, V7 and V10 by Kyas et al [2], normal tissue complication probability (NTCP) by Ricardi et al [3], lung volumes treated with doses higher than 2.5-50 Gy (V2.5-50) by Guckenberger et al [4], mean lung dose by Barriger et al [5] and contralateral V5 by Ong et al [6].We found a discrepancy in the significant clinical and dosimetric factors between the results of these five studies on low-grade RP [2-6] and our study on severe RP [1]. We speculated that the mechanism underlying the development of grade $3 RP might be different from that of grade 2 RP. Additionally, the treatment of grade $3 RP was much more critical than that of grade 2 RP. Most patients with grade $3 RP nee...

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contrasting

confidence: 74%

“…The patients' backgrounds were described in the previous report [1] (Table 1). There were 111 primary lung cancers and 22 metastatic lung tumours.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of clinical, tumour-related and dosimetric factors in grade 0–1, grade 2 and grade 3 radiation pneumonitis after stereotactic body radiotherapy for lung tumours

Takeda

Ohashi²,

Kunieda

et al. 2012

BJR

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Stereotactic body radiotherapy for pulmonary oligometastases as an initial metastasis‐directed therapy: patterns of relapse and predictive factors for early mortality

Yamamoto

Niibe

Aoki

et al. 2021

Precision Radiation Oncology

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Objective: This study aimed to analyze the early mortality rates and patterns of relapse after stereotactic body radiotherapy (SBRT) as an initial metastasis-directed therapy.Methods: Patients with pulmonary oligometastases initially treated with SBRT were included in this retrospective multicenter study. SBRT was performed between 2004 and 2015, and the primary lesion was controlled at the time of SBRT. Multivariate logistic regression was used for early mortality analyses.Results: A total of 720 patients with 793 oligometastatic tumors for whom the median follow-up period was 24.6 months were enrolled. The median overall survival period was 53.2 months. The 90-, 180-, and 360-day mortality rates were 1.1% (8 deaths), 2.4% (17 deaths), and 10.8% (71 deaths), respectively. During follow up, 422 patients relapsed. Over 329 patients had single-site relapse, the most frequent site was the lung in 176; 49 had local failure; and 42 had lymph node metastases. The maximum tumor diameter was significantly related to 90-day mortality. Maximum tumor diameter, biological effective dose, and performance status were significantly related to 180-day mortality, whereas maximum tumor diameter, performance status, and pathology were significantly related to 360-day mortality. Conclusion:Our results showed good survival outcomes and low rates of early mortality after SBRT. The patterns of relapse and factors affecting early mortality were revealed. K E Y W O R D Searly mortality, initial metastasis-directed therapy, patterns of relapse, pulmonary oligometastases, stereotactic body radiotherapyThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Reported Toxicities Associated with Stereotactic Body Radiation Therapy

Sahgal

Kunos

et al. 2011

Stereotactic Body Radiation Therapy

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Early Graphical Appearance of Radiation Pneumonitis Correlates With the Severity of Radiation Pneumonitis After Stereotactic Body Radiotherapy (SBRT) in Patients With Lung Tumors

Cited by 52 publications

References 27 publications

Comparison of clinical, tumour-related and dosimetric factors in grade 0–1, grade 2 and grade 3 radiation pneumonitis after stereotactic body radiotherapy for lung tumours

Comparison of clinical, tumour-related and dosimetric factors in grade 0–1, grade 2 and grade 3 radiation pneumonitis after stereotactic body radiotherapy for lung tumours

Stereotactic body radiotherapy for pulmonary oligometastases as an initial metastasis‐directed therapy: patterns of relapse and predictive factors for early mortality

Reported Toxicities Associated with Stereotactic Body Radiation Therapy

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