Pulmonary toxicity generated from radiotherapeutic treatment of thoracic malignancies

Deng, Guohua; Liang, Ning; Xie, Jian; Luo, Hui; Qiao, Lili; Zhang, Jingxin; Wang, Dawei; Zhang, Jiandong

doi:10.3892/ol.2017.6268

Cited by 21 publications

(27 citation statements)

References 96 publications

(149 reference statements)

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“…Tumor response was divided into complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD) according to the Response Evaluation Criteria In Solid Tumors (RECIST) criteria, and we defined CR or PR in the RT field area as the responding group [10]. Acute toxicity was evaluated by National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 [11].…”

Section: Discussionmentioning

confidence: 99%

Palliative external beam radiotherapy for lung cancer patients with malignant airway obstruction

Choi¹,

Jeong²,

Jeong³

et al. 2020

Preprint

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Background Significant proportion of lung cancer patients suffer from malignant airway obstruction (MAO). Palliative external beam radiotherapy (EBRT) is often attempted to control symptoms caused by MAO. In this study, we report the effect of palliative EBRT on lung cancer with MAO and analyze the factors that influence it. Methods This study included 75 patients with MAO in lung cancer who underwent palliative EBRT, between 2009 and 2018 and were analyzed retrospectively. Change of dyspnea, tumor response, and overall survival (OS) were recorded. Univariate and multivariate analyses were done to find the prognostic factors for treatment outcomes. Results The median follow-up duration was 2.5 months, and the median OS was 2.3 months. Out of 75 patients, dyspnea was improved in 46 patients (61.3%), and tumor was partially decreased in 39 patients (52%). The symptom improvement was significantly affected by tumor response and radiation dose. The tumor response was significantly affected by disease status, radiation dose, and time to EBRT.Conclusions Palliative EBRT is an effective and safe treatment option for patients with MAO in lung cancer. Especially, high-dose irradiation and prompt treatment can improve treatment results.

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Section: Discussionmentioning

confidence: 99%

Palliative external beam radiotherapy for lung cancer patients with malignant airway obstruction

Choi¹,

Jeong²,

Jeong³

et al. 2020

Preprint

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“…International Publisher radiation techniques to minimize the injury of normal tissue, pulmonary toxicity has always been an obstacle for them that cannot be bypassed. 2 The same restriction applies to the treatments of other thoracic malignancies, like esophageal cancer.…”

Section: Ivyspringmentioning

confidence: 99%

“…Depending on the methods of assessment, it has been estimated that about 5% to nearly 40% of lung cancer patients who underwent radiotherapy will develop RILI. 2 Since lung is a very radiosensitive organ, radiation pneumonitis can occur in a short period and lead to pulmonary insufficiency. Grade≥2 RP usually needs clinical interventions and about 10%-20% of them are severe RP (grade≥3).…”

Section: Ivyspringmentioning

confidence: 99%

“…Although 13-100% patients after the RT could be found had radiological signs of RILI in the images by computed tomography (CT), single-photon emission computerized tomography (SPECT), or magnetic resonance imaging (MRI), much less fraction of these patients will actually develop clinical symptoms. 2 Thus, reliable predictive methods are strongly desired by clinical radiologists.…”

Section: Ivyspringmentioning

confidence: 99%

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Precise prediction of the radiation pneumonitis in lung cancer: an explorative preliminary mathematical model using genotype information

Dai

et al. 2020

J. Cancer

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Purpose: Radiation pneumonitis (RP) is the most significant dose-limiting toxicity and is one major obstacle for lung cancer radiotherapy. Grade ≥2 RP usually needs clinical interventions and serve RP could be life threatening. Clinically, tissue response could be strikingly different even two similar patients after identical radiotherapy. Previous methods for the RP prediction can hardly distinguish substantial variations among individuals. Reliable predictive factors or methods emphasizing the individual differences are strongly desired by clinical radiation oncologists. The purpose of this study is to develop an approach for the personalized RP risk prediction. Experimental Design: One hundred eighteen lung cancer patients who received radiotherapy were enrolled. Seven hundred thousand single-nucleotide polymorphism (SNP) sites were assessed via Generalized Linear Models via Lasso and Elastic-Net Regularization (GLMNET) to determine their synergistic effects on the RP risk prediction. Non-genetic factors including patient's phenotypes and clinical interventional parameters were separately assessed by statistic test. Based on the results of the aforementioned analysis, a multiple linear regression model named Radiation Pneumonitis Index (RPI) was built, for the assessment of Grade ≥2RP risk. Results: Only previous surgery and fractional dose were discovered statistical significantly associated with grade ≥2RP. Thirty-nine effective SNPs for predicting the Grade ≥2RP risk were discovered and their coefficients of the synergistic effect were determined. The RPI score can successfully distinguish the RP≥2 population with 92.0% sensitivity and 100% specificity. Conclusions: Individual radiation sensitivity can be determined with genotype information and personalized radiotherapy could be achieved based on mathematical model result.

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“…Thoracic radiotherapy (TRT), particularly when delivered concurrently with chemotherapy, may result in acute and late toxicities (eg, dyspnea, reduced lung function) . Chemoradiation is often the definitive treatment for patients with thoracic malignancies (eg, lung and esophageal cancers) because they tend to be diagnosed with unresectable, locally advanced or even metastatic disease .…”

Section: Introductionmentioning

confidence: 99%

Dyadic yoga program for patients undergoing thoracic radiotherapy and their family caregivers: Results of a pilot randomized controlled trial

et al. 2019

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Objective Thoracic radiotherapy (TRT) may result in toxicities that are associated with performance declines and poor quality of life (QOL) for patients and their family caregivers. The purpose of this randomized controlled trial was to establish feasibility and preliminary efficacy of a dyadic yoga (DY) intervention as a supportive care strategy. Methods Patients with stage I to III non‐small cell lung or esophageal cancer undergoing TRT and their caregivers (N = 26 dyads) were randomized to a 15‐session DY or a waitlist control (WLC) group. Prior to TRT and randomization, both groups completed measures of QOL (SF‐36) and depressive symptoms (CES‐D). Patients also completed the 6‐minute walk test (6MWT). Dyads were reassessed on the last day of TRT and 3 months later. Results A priori feasibility criteria were met regarding consent (68%), adherence (80%), and retention (81%) rates. Controlling for relevant covariates, multilevel modeling analyses revealed significant clinical improvements for patients in the DY group compared with the WLC group for the 6MWT (means: DY = 473 m vs WLC = 397 m, d = 1.19) and SF‐36 physical function (means: DY = 38.77 vs WLC = 30.88; d = .66) and social function (means: DY = 45.24 vs WLC = 39.09; d = .44) across the follow‐up period. Caregivers in the DY group reported marginally clinically significant improvements in SF‐36 vitality (means: DY = 53.05 vs WLC = 48.84; d = .39) and role performance (means: DY = 52.78 vs WLC = 48.59; d = .51) relative to those in the WLC group. Conclusions This novel supportive care program appears to be feasible and beneficial for patients undergoing TRT and their caregivers. A larger efficacy trial with a more stringent control group is warranted.

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Pulmonary toxicity generated from radiotherapeutic treatment of thoracic malignancies

Cited by 21 publications

References 96 publications

Palliative external beam radiotherapy for lung cancer patients with malignant airway obstruction

Palliative external beam radiotherapy for lung cancer patients with malignant airway obstruction

Precise prediction of the radiation pneumonitis in lung cancer: an explorative preliminary mathematical model using genotype information

Dyadic yoga program for patients undergoing thoracic radiotherapy and their family caregivers: Results of a pilot randomized controlled trial

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