Risk of Pneumonitis After Stereotactic Body Radiation Therapy in Patients With Previous Anatomic Lung Resection

Hayes, J.T.; David, Elizabeth A.; Qi, Lihong; Chen, Allen M.; Daly, Megan E.

doi:10.1016/j.cllc.2015.01.006

Cited by 12 publications

(9 citation statements)

References 25 publications

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“…Second, the calculated one-third residual postradiotherapy volume, the critical volume, can be too small to maintain function and cause a predisposition for radiation pneumonitis in patients with a partially reduced lung volume after previous surgeries or radiation therapy. In agreement with our study, other studies (23,42) have suggested that further research should be undertaken for verification. Minimising the irradiated volume is important for reducing the risk for development of pneumonitis.…”

Section: Impact Of the Dose-volume And The Total Lung Volume On Radiation Pneumonitis After Sbrt In Nsclcsupporting

confidence: 93%

Lung Function After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer, Changes and Predictive Markers

et al. 2021

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IntroductionThe present study explores changes in pulmonary function, symptoms and radiological signs of pneumonitis after curatively intended stereotactic body radiation therapy (SBRT).MethodsAll inoperable, early-stage non-small cell lung cancer patients treated with stereotactic body radiation therapy (SBRT) from 2014-2017 were included in this single-centre study. They were followed regularly for 12 months after treatment. The patients were classified into three groups based on radiology and symptomatology: no radiation pneumonitis, asymptomatic and symptomatic radiation pneumonitis.ResultsForty-four patients with stage IA-IIB disease were treated with 45–56 Gy in 3–8 fractions. The median age was 75 years, 43% of the patients were female; 60% of the patients had a COPD in GOLD grade of 2-4, and 95.5% were active or former smokers. Symptomatic radiation pneumonitis occurred in 18% of the patients and asymptomatic pneumonitis as defined by radiology, in 39%. The mean of forced expiratory volume in 1 second (FEV1) and diffusion capacity for carbon monoxide (DLCO) decreases for all patients during the first years were higher than one would expect from physiologic ageing. FEV1 and DLCO in percent decrease 7-8% at 1-1.5 months in the symptomatic radiation pneumonitis group. CT scan findings consistent with radiation pneumonitis occurred after a median of 2.9 months in the symptomatic and 5.4 months in the asymptomatic radiation pneumonitis groups. In the group with symptomatic radiation pneumonitis, symptoms, as measured by the Clinical COPD questionnaire score, significantly increased at 3 and 6 months. Significant higher maximum doses to the critical lung volumes DC1000cm3 (1000 cm3 of lung receiving a given dose or less) and DC 1500cm3 (1500 cm3 of lung receiving a given dose or less) were observed in patients who developed radiation pneumonitis.ConclusionEarly decrease in measured FEV1 and DLCO occurred before imaging changes and symptoms and might indicate the development of symptomatic radiation pneumonitis. The dose to critical lung volumes of DC1000 cm3 and DC1500 cm3 may predict the risk for the development of symptomatic radiation pneumonitis.

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Section: Impact Of the Dose-volume And The Total Lung Volume On Radiation Pneumonitis After Sbrt In Nsclcsupporting

confidence: 93%

Lung Function After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer, Changes and Predictive Markers

et al. 2021

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“…These showed a significantly better OS with SBRT compared to CFRT, similar to patients with an inoperable stage I NSCLC (1). Following CFRT the reported rates of the 2-year OS and grade 3 toxicity or higher have been shown to be in the range: 30-73% and 0%, respectively (4-7) and following SBRT 61-91% and 2-15%, respectively (8)(9)(10)(11)(12). We consider our results to be comparable to the published results.…”

Section: Discussionsupporting

confidence: 86%

“…Regarding toxicities, a retrospective study of patients with or without a history of lung resection has shown that grade 2 pulmonary toxicity or higher following SBRT tended to increase in patients with previous lung resection compared to others, although there was no trend for grade 2 radiationinduced pneumonitis or higher (12). In our study, grade 3 dyspnea occurred in 2 patients, despite their slight radiological changes following SBRT.…”

Section: Discussioncontrasting

confidence: 52%

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Comparison Between Stereotactic and Conventional Radiotherapy for Solitary Lung Tumor After Resection of Lung Cancer

Takahashi

Anada

et al. 2019

Anticancer Res

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Background/Aim: We retrospectively compared stereotactic body radiotherapy (SBRT) with conventionally fractionated radiotherapy (CFRT) for a solitary lung tumor after resection of a non-small cell lung cancer (NSCLC), due to a lack of data concerning whether SBRT or CFRT is more effective in this setting. Patients and Methods: SBRT using 48 Gy in 4 fractions was administered to 15 patients with a peripheral tumor (SBRT group). CFRT using 66-70 Gy in 33-35 fractions was administered to 11 patients with a central tumor (CFRT group). Results: The median follow-up time was 32 months (range: 9-79 months). The 3-year overall survival rates in SBRT and CFRT groups were 81% and 40%, respectively (p=0.008). The 3-year local control rates in SBRT and CFRT groups were 83% and 35%, respectively (p=0.035). Regarding toxicities, no significant differences were found between the two groups. Conclusion: Compared to CFRT, SBRT may be more effective in solitary-lung-tumor patients after the complete resection of an NSCLC as with inoperable-stage I-NSCLC patients.

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“…Among all clinical parameters, only one parameter, previous history of surgery showed statistical significance, which was in consistent with previous report. 13 As for other non-genetic parameters particularly the most important dosimetric parameters, the only factors that showed statistical significance is the fractional dose (Table 3), with the p-value of 0.029.…”

Section: Clinical and Other Non-genetic Factorsmentioning

confidence: 97%

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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Risk of Pneumonitis After Stereotactic Body Radiation Therapy in Patients With Previous Anatomic Lung Resection

Cited by 12 publications

References 25 publications

Lung Function After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer, Changes and Predictive Markers

Lung Function After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer, Changes and Predictive Markers

Comparison Between Stereotactic and Conventional Radiotherapy for Solitary Lung Tumor After Resection of Lung Cancer

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

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