Patient’s quality of life after high-dose radiation therapy for thoracic carcinomas

Schröder, Christina; Engenhart‐Cabillic, Rita; Vorwerk, Hilke; Schmidt, Michael A.; Huhnt, Winfried; Blank, Eyck; Sidow, Dietrich; Buchali, A.

doi:10.1007/s00066-016-1068-7

Cited by 12 publications

(8 citation statements)

References 19 publications

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“…Dose prescription to the lung is limited because of a high risk of pneumonitis, an inflammatory condition of the lung tissue caused by irradiation, which frequently results in lung fibrosis, leading to a severely reduced quality of life. 3 The fairly recent concept of stereotactic body radiation therapy offers patients with small lung tumors a much shorter treatment concept. However, such concepts are applicable only to a limited number of small peripheral lesions.…”

Section: Introductionmentioning

confidence: 99%

A Mouse Model for Microbeam Radiation Therapy of the Lung

Schültke

Bayat

Bartzsch

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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Purpose: Radiation therapy is an important treatment component for patients with lung cancer. However, the survival time gained with clinical radiation therapy techniques is relatively short. Data from preclinical experiments suggest that synchrotron microbeam radiation therapy could be much better suited to control malignant brain tumors than current clinical concepts of radiation therapy. Even at peak doses of several hundred gray, the extent of functional deficits is low. Methods and Materials: We have developed the first mouse model to study the effects of microbeam irradiation in lung

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Section: Introductionmentioning

confidence: 99%

A Mouse Model for Microbeam Radiation Therapy of the Lung

Schültke

Bayat

Bartzsch

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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“…Such an approach to assessment of dyspnea had been suggested in a systematic review of the available tools (22) and a 10% change from baseline values is a reasonable measure of a clinically meaningful change (23). The dyspnea scales used in this study were demonstrated as a valid and reliable tool in a range of cancer patient populations, including lung cancer patients, and confirmed to reflect the common symptoms and treatment-related toxicities underlying radio(chemo)therapy (24). Another limitation of the study is the multiple testing in a small number of patients and the associated increased potential for Type I error in the results.…”

Section: Discussionmentioning

confidence: 86%

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

et al. 2020

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Background and PurposeDyspnea is an important symptomatic endpoint for assessment of radiation-induced lung injury (RILI) following radical radiotherapy in locally advanced disease, which remains the mainstay of treatment at the time of significant advances in therapy including combination treatments with immunotherapy and chemotherapy and the use of local ablative radiotherapy techniques. We investigated the relationship between dose-volume parameters and subjective changes in dyspnea as a measure of RILI and the relationship to spirometry.Material and MethodsEighty patients receiving radical radiotherapy for non-small cell lung cancer were prospectively assessed for dyspnea using two patient-completed tools: EORTC QLQ-LC13 dyspnea quality of life assessment and dyspnea visual analogue scale (VAS). Global quality of life, spirometry and radiation pneumonitis grade were also assessed. Comparisons were made with lung dose-volume parameters.ResultsThe median survival of the cohort was 26 months. In the evaluable group of 59 patients there were positive correlations between lung dose-volume parameters and a change in dyspnea quality of life scale at 3 months (V30 p=0.017; V40 p=0.026; V50 p=0.049; mean lung dose p=0.05), and a change in dyspnea VAS at 6 months (V30 p=0.05; V40 p=0.026; V50 p=0.028) after radiotherapy. Lung dose-volume parameters predicted a 10% increase in dyspnea quality of life score at 3 months (V40; p=0.041, V50; p=0.037) and dyspnea VAS score at 6 months (V40; p=0.027) post-treatment.ConclusionsWorsening of dyspnea is an important symptom of RILI. We demonstrate a relationship between lung dose-volume parameters and a 10% worsening of subjective dyspnea scores. Our findings support the use of subjective dyspnea tools in future studies on radiation-induced lung toxicity, particularly at doses below conventional lung radiation tolerance limits.

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“…It should also be noted that cardiac and pulmonary toxicities continue to manifest after longer time intervals than the three months studied here. Furthermore, grade 2 side effects, including esophagitis and pneumonitis, commonly deteriorate the patient-reported quality of life and should not be neglected [20,21].…”

Section: Discussionmentioning

confidence: 99%

Early High-Grade Thoracic Toxicity After Palliative Radiotherapy for Non-Small Cell Lung Cancer

Nieder¹,

Imingen²

2021

Cureus

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Introduction: Palliative radiotherapy or chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) may cause thoracic toxicities due to the radiation dose delivered to the lungs, heart, and esophagus. We studied severe thoracic toxicities resulting in hospitalization or death during the acute and sub-acute phase, i.e., three months from commencing radiotherapy. In addition, risk factors were identified. Methods: A retrospective review of 165 patients treated with three-dimensional conformal palliative radiotherapy or CRT was performed. The prescribed total dose was equivalent to at least 30 Gy in 10 fractions. Uni- and multivariate analyses were employed. Results: Twelve patients (7%) were hospitalized within three months from the start of radiotherapy or CRT. Six patients were hospitalized for esophagitis, three for dyspnea most likely caused by pneumonitis, and three for cardiac arrhythmia. Fatal toxicity was not observed. However, 19% of the 165 patients died from tumor-related causes during the time period of interest. In multivariate analysis, the only esophageal dose was significantly associated with the risk of hospitalization. Conclusion: The safety profile of palliative radiotherapy or CRT in the acute and subacute phases was satisfactory. The hospitalization rate can be reduced by lowering the esophageal dose, as long as safe lung and heart doses can be maintained.

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Patient’s quality of life after high-dose radiation therapy for thoracic carcinomas

Abstract: 12 weeks after RT the QLQ-C30 functional scales show the highest scores or at least a temporary recovery. The symptom scales accurately reflect the common symptoms and treatment-related toxicities. QoL did not prove to be a significant predictor for local and distant control or survival.

Cited by 12 publications

References 19 publications

A Mouse Model for Microbeam Radiation Therapy of the Lung

A Mouse Model for Microbeam Radiation Therapy of the Lung

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

Early High-Grade Thoracic Toxicity After Palliative Radiotherapy for Non-Small Cell Lung Cancer

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