Risk factors of pneumonitis following chemoradiotherapy for lung cancer

Yamada, Masashi; Kudoh, Shinzoh; Hirata, Kazuto; Nakajima, Toshifumi; Yoshikawa, Junichi

doi:10.1016/s0959-8049(97)00377-8

Cited by 128 publications

(62 citation statements)

References 19 publications

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“…Therefore, the addition of concurrent or induction chemotherapy to hypofractionated radiation might be the cause of higher incidence of $Grade 3 TRP. Several studies have shown the incidence of TRP was higher for concurrent chemotherapy with radiotherapy (22,23). After the analyses to detect the predictive factors for $Grade 3 TRP, CL V 5 was found to be the only independent determinant in current study.…”

Section: Discussionmentioning

confidence: 45%

Treatment-Related Pneumonitis and Acute Esophagitis in Non–Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Song¹,

Pyo²,

Moon³

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 45%

Treatment-Related Pneumonitis and Acute Esophagitis in Non–Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Song¹,

Pyo²,

Moon³

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…A number of clinical studies, including Yorke et al from Memorial and Seppenwoolde et al from NKI, have shown that radiation dose to the lower lung may be more associated with lung injury than radiation dose to the upper lung [16,26]. Other studies such as Hope et al from Washington University and Yamada et al from Japan have found that the incidence of pneumonitis is higher in patients with lower lobe tumors [27,28]. Our group has also looked for this effect in our data and has not seen this [29].…”

Section: Discussionmentioning

confidence: 99%

Prospective assessment of dosimetric/physiologic-based models for predicting radiation pneumonitis

Koçak

Borst

Zeng

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose-Clinical and 3D dosimetric parameters are associated with symptomatic radiation pneumonitis rates in retrospective studies. Such parameters include: mean lung dose (MLD), radiation (RT) dose to perfused lung (via SPECT), and pre-RT lung function. Based on prior publications, we defined pre-RT criteria hypothesized to be predictive for later development of pneumonitis. We herein prospectively test the predictive abilities of these dosimetric/functional parameters on two cohorts of patients from Duke and the Netherlands Cancer Institute (NKI).Methods and Materials-For the Duke cohort, 55 eligible patients treated between 1999-2005 on a prospective IRB-approved study to monitor RT-induced lung injury were analyzed. A similar group of patients treated at the NKI between 1996-2002 were identified. Patients believed to be at high and low risk for pneumonitis were defined based on: a) MLD; b) OpRP (sum of predicted perfusion reduction based on regional dose response curve); and c) pre-RT DLCO. All doses reflected tissue density heterogeneity. The rates of grade ≥2 pneumonitis in the "presumed" high and low risk groups were compared using Fisher's exact test.Results-In the Duke group, pneumonitis rates in patients prospectively deemed to be at "high" vs. "low" risk are 7/20 and 9/35, respectively; p=0.33 one tailed Fisher's. Similarly, comparable rates for the NKI group are 4/21 and 6/44, respectively, p=0.41 one-tailed Fisher's. Conclusion-The prospective model is unable to accurately segregate patients into high vs. low risk groups. However, considered retrospectively, these data are consistent with prior studies suggesting that dosimetric (e.g. MLD) and functional (e.g. PFTs or SPECT) parameters are predictive Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errorsmaybe discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. for RT-induced pneumonitis. Additional work is needed to better identify, and prospectively assess, predictors of RT-induced lung injury. NIH Public Access

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“…Thus, the prevention of rili with novel drugs represents a new avenue for dealing with these side effects of radiation therapy. Several clinical factors are associated with lung toxicity, including tumor location (28)(29)(30), patient performance status (31,32), pulmonary function before radiotherapy (32) and smoking status (31,33). in addition, many studies have demonstrated that dosimetric factors are crucial for the estimation of lung tolerance, including mean lung dose, the percentage of the total lung volume exceeding 20 Gy (V20), the percentage of the total lung volume exceeding 30 Gy (V30), effective volume and normal tissue complication probability from the lung dose-volume histogram (34)(35)(36)(37).…”

Section: Tnf-α and Tgf-β1 Expression Based On Rt-pcr Analysismentioning

confidence: 99%

Modulation of radiation-induced tumour necrosis factor-α and transforming growth factor β1 expression in the lung tissue by Shengqi Fuzheng injection

Dong

Wang²,

Liu³

et al. 2010

Mol Med Rep

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Abstract. radiation-induced lung injury (rili) is one of the most common and severe side effects of thoracic radiotherapy. Therefore, novel therapeutic approaches to improve the effectiveness of rili treatment are required. The present study was designed to determine the effectiveness of a traditional chinese medicine regimen, Shenqi Fuzheng injection (SFi), in the treatment of rili. SFi is composed of extracts from codonopsis pilosula and radix astragali. Here, we determined the protective effects of SFi on rili with a single-dose irradiation (rT) of 12 Gy in c57Bl/6 8-week-old mice. The mice were divided into four groups treated with i) phosphatebuffered saline (PBS; pH 7.4, 20 ml/kg/day) alone as normal a control; ii) SFi only (20 ml/kg/day); iii) rT + PBS (20 ml/ kg/day); and iv) rT + SFi (20 ml/kg/day). SFi and PBS were administered via intraperitoneal injection 1 week before and 2 weeks after rT. The pathology of rili and any clinical signs of toxicity were monitored. The expression of tumour necrosis factor (TnF)-α and transforming growth factor (TGF)-β1 in the lungs was analyzed by rT-Pcr and immunohistochemistry. TnF-α and TGF-β1 expression was increased by rT, but was reversed by SFi treatment during the radiation pneumonic and fibrotic phases (P<0.05). Lung histology at 24 weeks revealed a significant decrease in structural damage and collagen deposition in the rT + SFi group compared to the rT + PBS group. in conclusion, TnF-α and TGF-β1 are key mediators for the pathogenesis of rili, and SFi reduces TnF-α and TGF-β1 expression after rT. This may be a key mechanism behind the preventive effects of SFi on lung injury after radiation.

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Risk factors of pneumonitis following chemoradiotherapy for lung cancer

Cited by 128 publications

References 19 publications

Treatment-Related Pneumonitis and Acute Esophagitis in Non–Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Treatment-Related Pneumonitis and Acute Esophagitis in Non–Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Prospective assessment of dosimetric/physiologic-based models for predicting radiation pneumonitis

Modulation of radiation-induced tumour necrosis factor-α and transforming growth factor β1 expression in the lung tissue by Shengqi Fuzheng injection

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