Early pulmonary toxicity following lung stereotactic body radiation therapy delivered in consecutive daily fractions

Stauder, Michael C.; Macdonald, O. Kenneth; Olivier, Kenneth R.; Call, Jason A.; Lafata, Kyle; Mayo, Charles S.; Miller, Robert C.; Brown, Paul D.; Bauer, Heather; Garces, Yolanda I.

doi:10.1016/j.radonc.2011.04.002

Cited by 62 publications

(39 citation statements)

References 32 publications

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“…Multiple clinical factors, including tumor volume, dose, and smoking history, have been implicated in the pathogenesis of radiation pneumonitis, but immune parameters have not been fully evaluated. 29,30 The assumption has been that radiation pneumonitis is driven through the engagement of inflammatory pathways with a predominantly Th2 composition that ultimately leads to lung inflammation and the clinical manifestation of pneumonitis. 31,32 A potential explanation for why a higher NLR might protect against radiation pneumonitis is that high NLRs suggest that the inflammatory responses are already active and that this baseline inflammation, in turn, might suppress the activity of other, competing immune cells, including lymphocytes, activated T cells, and natural killer cells that would have otherwise become mobilized by the radiation treatment.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Immune Parameters Predict for Overall Survival and Toxicity in Early-Stage Non–Small-Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy

Shaverdian

Veruttipong

Wang

et al. 2016

Clinical Lung Cancer

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Section: Discussionmentioning

confidence: 99%

Pretreatment Immune Parameters Predict for Overall Survival and Toxicity in Early-Stage Non–Small-Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy

Shaverdian

Veruttipong

Wang

et al. 2016

Clinical Lung Cancer

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“…Scoring systems should be considered when interpreting RP results. The reported rates of symptomatic RP after SBRT range from 9% to 28% [8,10,11,[28][29][30][31] . Although most of the RP was Grade 1 or 2 and either asymptomatic or Yamashita H et al .…”

Section: Rp After Sbrtmentioning

confidence: 99%

Radiation pneumonitis after stereotactic radiation therapy for lung cancer

Yamashita

Takahashi

Haga

et al. 2014

WJR

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Stereotactic body radiation therapy (SBRT) has a local control rate of 95% at 2 years for non-small cell lung cancer (NSCLC) and should improve the prognosis of inoperable patients, elderly patients, and patients with significant comorbidities who have early-stage NSCLC. The safety of SBRT is being confirmed in international, multi-institutional Phase Ⅱ trials for peripheral lung cancer in both inoperable and operable patients, but reports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer. Radiation pneumonitis (RP) is one of the most common toxicities of SBRT. Although most post-treatment RP is Grade 1 or 2 and either asymptomatic or manageable, a few cases are severe, symptomatic, and there is a risk for mortality. The reported rates of symptomatic RP after SBRT range from 9% to 28%. Being able to predict the risk of RP after SBRT is extremely useful in treatment planning. A dose-effect relationship has been demonstrated, but suggested dose-volume factors like mean lung dose, lung V20, and/or lung V2.5 differed among the reports. We found that patients who present with an interstitial pneumonitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumonitis after SBRT. At our institution, lung cancer patients with these risk factors have not received SBRT since 2006, and our rate of severe RP after SBRT has decreased significantly since then.

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“…2 RP in the whole series was in accordance with the reported incidence for patients undergoing SBRT for lung lesions. 3,[10][11][12][13] Thus, in the RAS inhibitor group, only 3 patients developed symptomatic RP compared with 19 patients in the non-RAS inhibitor group. The retrospective nature and relatively low number of patients analyzed were the main limitations of our study.…”

Section: Discussionmentioning

confidence: 96%

“…8,9 The incidence of symptomatic radiation pneumonitis (RP) after SBRT is usually low, ranging from 9% to 28%. 3,[10][11][12][13] The volumes treated are typically small, allowing the delivery of high radiation doses to the target volume, sparing the surrounding healthy tissue, reflected in the low rate of RP observed. However, SBRT might not be tolerated because most patients will have advanced age and/or comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Renin-Angiotensin System Inhibitors Might Help to Reduce the Development of Symptomatic Radiation Pneumonitis After Stereotactic Body Radiotherapy for Lung Cancer

Bracci

Valeriani

Agolli

et al. 2016

Clinical Lung Cancer

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Early pulmonary toxicity following lung stereotactic body radiation therapy delivered in consecutive daily fractions

Cited by 62 publications

References 32 publications

Pretreatment Immune Parameters Predict for Overall Survival and Toxicity in Early-Stage Non–Small-Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy

Pretreatment Immune Parameters Predict for Overall Survival and Toxicity in Early-Stage Non–Small-Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy

Radiation pneumonitis after stereotactic radiation therapy for lung cancer

Renin-Angiotensin System Inhibitors Might Help to Reduce the Development of Symptomatic Radiation Pneumonitis After Stereotactic Body Radiotherapy for Lung Cancer

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