Incidence and Prognostic Factors of Radiation Pneumonitis in NSCLC Treated with Intensity Modulated Radiation Therapy (IMRT)

Kim, Myung Se

doi:10.3857/jkstro.2008.26.1.35

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…This corresponded to a decrease of > 2 Gy in the total lung mean dose and of 10% in the risk of radiation pneumonitis. Kim [ 36 ] reported that of 105 NSCLC patients treated with IMRT, 21 patients (20%) had abnormal radiological findings, but only seven patients (6.7%) required treatment for radiation pneumonitis and suggested that IMRT could be a beneficial treatment modality for the reduction of radiation pneumonitis in NSCLC patients.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

Kim

Lee

et al. 2011

Radiat Oncol J

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PurposeThoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy. This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after definitive radiotherapy in stage III non-small cell cancer patients.Materials and MethodsThe medical records were reviewed for 49 patients who completed definitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently.ResultsTwenty-five cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location, total radiation dose and chemotherapy were associated with grade ≥2 radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was significantly related to grade ≥2 radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), V20, V30, V40, MLDipsi, V20ipsi, V30ipsi, and V40ipsi were associated with grade ≥2 radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ≥2 radiation pneumonitis.ConclusionConcurrent chemotherapy, MLD and V30 were statistically significant predictors of grade ≥2 radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing definitive radiotherapy. The cutoff values for MLD and V30 were 16 Gy and 18%, respectively.

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Section: Discussionmentioning

confidence: 99%

Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

Kim

Lee

et al. 2011

Radiat Oncol J

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“…There have been various proposals to generate directional beams for LDR permanent seed brachytherapy applications as well that deserve a review. Essentially the concept of achieving directional beams is identical to those of the HDR IMBT solutions where high density shielding are incorporated into the source/applicator designs (Kim et al 2003, Lin et al 2008, Chaswal et al 2012, Rivard 2017. One of the first conceptual design was proposed by Kim et al (2003), where a beta-emitting 90 Sr/Y source was encased in a thin stainless steel or tungsten shield to deliver a hypothetical intensity modulated intravascular brachytherapy.…”

Section: Directional Sourcesmentioning

confidence: 99%

“…Essentially the concept of achieving directional beams is identical to those of the HDR IMBT solutions where high density shielding are incorporated into the source/applicator designs (Kim et al 2003, Lin et al 2008, Chaswal et al 2012, Rivard 2017. One of the first conceptual design was proposed by Kim et al (2003), where a beta-emitting 90 Sr/Y source was encased in a thin stainless steel or tungsten shield to deliver a hypothetical intensity modulated intravascular brachytherapy. Lin et al (2008), followed up with a 125 I source design that incorporated gold as the shielding material of choice, as illustrated in figure 2(C), to generate a heavily-skewed anisotropic dose distribution (analogous to figure 5).…”

Section: Directional Sourcesmentioning

confidence: 99%

Emerging technologies in brachytherapy

Song¹,

Robar²,

Morén³

et al. 2021

Phys. Med. Biol.

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Brachytherapy is a mature treatment modality. The literature is abundant in terms of review articles and comprehensive books on the latest established as well as evolving clinical practices. The intent of this article is to part ways and look beyond the current state-of-the-art and review emerging technologies that are noteworthy and perhaps may drive the future innovations in the field. There are plenty of candidate topics that deserve a deeper look, of course, but with practical limits in this communicative platform, we explore four topics that perhaps is worthwhile to review in detail at this time. First, intensity modulated brachytherapy (IMBT) is reviewed. The IMBT takes advantage of anisotropic radiation profile generated through intelligent high-density shielding designs incorporated onto sources and applicators such to achieve high quality plans. Second, emerging applications of 3D printing (i.e. additive manufacturing) in brachytherapy are reviewed. With the advent of 3D printing, interest in this technology in brachytherapy has been immense and translation swift due to their potential to tailor applicators and treatments customizable to each individual patient. This is followed by, in third, innovations in treatment planning concerning catheter placement and dwell times where new modelling approaches, solution algorithms, and technological advances are reviewed. And, fourth and lastly, applications of a new machine learning technique, called deep learning, which has the potential to improve and automate all aspects of brachytherapy workflow, are reviewed. We do not expect that all ideas and innovations reviewed in this article will ultimately reach clinic but, nonetheless, this review provides a decent glimpse of what is to come. It would be exciting to monitor as IMBT, 3D printing, novel optimization algorithms, and deep learning technologies evolve over time and translate into pilot testing and sensibly phased clinical trials, and ultimately make a difference for cancer patients. Today’s fancy is tomorrow’s reality. The future is bright for brachytherapy.

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“…전형적인 방사 선 소견은 방사선 치료 부위의 형태와 일치하는 간유리 음영(ground glass opacity)소견이다 (50). 방사선 폐 손상은 특징적으로 해부학적 구조와 무관하여 엽간열(lobar fissure)이나 폐분절과 같은 폐의 경계에 무관하게 나타 난다 (Figure 3) (52,53). 일반적으로 방사선 폐렴은 보존적 치료로 수주에서 수개월에 걸쳐서 회복된다 (11).…”

Section: 중추신경계 부작용 및 대처법unclassified

The Adverse Effects of Radiotherapy and Its Management in the Hospice and Palliative Care Patients

Lee

Park

Han

et al. 2011

Korean J Hosp Palliat Care

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Recent advances in techniques and strategies use to detect cancer in its early stages and to treat it effectively has the survival rate of cancer patients and the number of long-term cancer survivors continually increasing. Unfortunately, many cancer survivors are at risk for various late and long-term effects of cancer treatments including the radiotherapy. Long-term cancer survivors can be also seen for a hospice and palliative care because of cancer recurrence and they are at risk of delayed reactions to radiotherapy. So, the understanding and knowledge of radiation reactions is required for the proper medical diagnosis, management, and coordination of the potential reactions that may occur in these care setting. In effort to increase the survival rate in cancer patients and to decrease the adverse effects of cancer treatment, many clinical studies have been and continue to be conducted. The efforts of these studies have thus resulted in the advancement of cancer treatments. Regrettably, the overall interest in how to manage adverse effects of cancer treatment such as radiotherapy appears seemingly low in clinical practice and its advanced studies as a whole are delayed and deficient. It is imperative that the medical community show an enthusiastic interest in the aftercare of cancer patients and cancer survivors in order to create a complementary integrative approach that will eliminate radiotherapy related pain/discomfort or illness in hospice and palliative care settings. (Korean J Hosp Palliat Care 2011;14:61-70)

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Incidence and Prognostic Factors of Radiation Pneumonitis in NSCLC Treated with Intensity Modulated Radiation Therapy (IMRT)

Cited by 3 publications

References 23 publications

Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

Emerging technologies in brachytherapy

The Adverse Effects of Radiotherapy and Its Management in the Hospice and Palliative Care Patients

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