Stereotactic Body Radiation Therapy for Patients with Pulmonary Interstitial Change: High Incidence of Fatal Radiation Pneumonitis in a Retrospective Multi-Institutional Study

Oda, Hiroshi; Yamashita, Hideomi; Shioyama, Yoshiyuki; Matsumoto, Yasuo; Takayama, Kenji; Matsuo, Yukinori; Miyakawa, A.; Matsushita, Haruo; Aoki, Masahiko; Nihei, Keiji; Kimura, Tomoki; Ishiyama, Hiromichi; Murakami, Naoya; Nakata, Kensei; Takeda, Atsuya; Umemura, Takashi; Nomiya, Takuma; Takanaka, Tuyoshi; Seo, Yuji; Komiyama, Takafumi; Marino, Kan; Aoki, Shin; Saito, Ryo; Araya, Masayuki; Maehata, Yoshiyasu; Tominaga, Licht; Kuriyama, Kinya

doi:10.3390/cancers10080257

Cited by 36 publications

(33 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A retrospective analysis reported that V5 was significantly associated with the occurrence of RP grade progression after carbon-ion radiotherapy for NSCLC with ILD [ 28 ]. Onishi et al [ 29 ] found that a V20 ≥ 10% is a major risk factor for severe RP in stage I NSCLC patients with subclinical ILD. In the present study, no correlation was observed between the incidence of RP and V20.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for radiation pneumonitis in lung cancer patients with subclinical interstitial lung disease after thoracic radiation therapy

Liu

et al. 2021

Radiat Oncol

View full text Add to dashboard Cite

Background Previous studies have found that patients with subclinical interstitial lung disease (ILD) are highly susceptible to developing radiation pneumonitis (RP) after thoracic radiation therapy. In the present study we aimed to evaluate the incidence of and risk factors for RP after thoracic intensity-modulated radiation therapy in lung cancer patients with subclinical ILD. Methods We retrospectively analyzed data from lung cancer patients with subclinical ILD who were treated with thoracic intensity-modulated radiation therapy with a prescribed dose of ≥ 50 Gy in our institution between January 2016 and December 2017. Results Eighty-seven consecutive lung cancer patients with subclinical ILD were selected for the study. The median follow-up period was 14.0 months. The cumulative incidence of grades ≥ 2 and ≥ 3 RP at one year was 51.0% and 20.9%, respectively. In the multivariate analysis, a mean lung dose ≥ 12 Gy was a significant risk factor for grade ≥ 2 RP (p = 0.049). Chemotherapy with gemcitabine in the past, V5 ≥ 50%, and subclinical ILD involving ≥ 25% of the lung volume were significantly associated with grade ≥ 3 RP (p = 0.046, p = 0.040, and p = 0.024, respectively). Conclusion Mean lung dose is a significant risk factor for grade ≥ 2 RP. Lung cancer patients who have received chemotherapy with gemcitabine in the past, V5 ≥ 50%, and those with subclinical ILD involving ≥ 25% of lung volume have an increased risk of grade ≥ 3 RP in lung cancer patients with subclinical ILD.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for radiation pneumonitis in lung cancer patients with subclinical interstitial lung disease after thoracic radiation therapy

Liu

et al. 2021

Radiat Oncol

View full text Add to dashboard Cite

show abstract

“…A retrospective analysis reported V5 was signi cantly associated with the occurrence of RP grade progression after Carbon-ion radiotherapy for NSCLC with interstitial lung disease [28]. In addition, Onishi et al [29] found that V20 ≥10% is a major risk factor for severe RP in stage I NSCLC patients with subclinical ILD. In the present study, no correlation was observed between the incidence of RP and V20.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Radiation Pneumonitis in Lung Cancer Patients with Subclinical Interstitial Lung Disease after Thoracic Radiation Therapy

Liu

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Previous studies have found that patients with subclinical interstitial lung disease (ILD) are more susceptible to developing radiation pneumonitis (RP) after thoracic radiation therapy. The present study aimed to evaluate the incidence of and risk factors for RP after thoracic intensity-modulated radiation therapy (IMRT) in lung cancer patients with subclinical ILD.Methods: We retrospectively analyzed lung cancer patients with subclinical ILD who were treated with thoracic IMRT with a prescribed dose of ≥50 Gy in our institutions between January 2016 and December 2017.Results: A total of 87 consecutive lung cancer patients with subclinical ILD were selected for the study. The cumulative incidence of grades ≥2 and ≥3 RP at one year was 51.0% and 20.9%, respectively. In the multivariate analysis, the mean lung dose (MLD) ≥12Gy was a significant risk factor for grade ≥2 RP (p = 0.049). Chemotherapy with gemcitabine in the past，V5≥50%，and subclinical ILD involving ≥25% of lung volume were significantly associated with grade ≥3 RP (p = 0.046, p = 0.040, and p = 0.024, respectively).Conclusion: MLD is a significant risk factor for grade ≥2 RP. Lung cancer patients who have received chemotherapy with gemcitabine in the past, V5, and those with subclinical ILD involving ≥25% of lung volume have an increased risk of grade ≥3 RP in lung cancer patients with subclinical ILD.

show abstract

“…When severe ILD is present, radiotherapy for inoperable LC is contraindicated because it causes radiation pneumonitis in up to 43% of patients [39]. Subclinical ILD is also considered a radiation-pneumonitis risk factor with some attributable fatalities, hence, the indication of radiotherapy, even stereotactic, should be decided by carefully considering the risks and benefits for ILD patients [40]. In our cohort, eight LC-ILD patients underwent radiotherapy: two (25%) developed non-severe radiation pneumonitis, statistically comparable to LC-noILD (12%) patients (see Supplementary Table S4).…”

Section: Discussionmentioning

confidence: 99%

Interstitial Lung Disease Associated with Lung Cancer: A Case–Control Study

Gibiot

Monnet

Lévy

et al. 2020

JCM

View full text Add to dashboard Cite

Interstitial lung disease (ILD) seems to be associated with an increased risk of lung cancer (LC) and to have a poorer prognosis than LC without ILD. The frequency of ILD in an LC cohort and its prognosis implication need to be better elucidated. This retrospective, observational, cohort study evaluated the frequency of ILD among LC patients (LC–ILD) diagnosed over a 2-year period. LC–ILD patients’ characteristics were compared to those with LC without ILD (LC–noILD). Lastly, we conducted a case–control study within this cohort, matching three LC–noILDs to each LC–ILD patient, to evaluate the ILD impact on LC patients’ prognoses. Among 906 LC patients, 49 (5.4%) also had ILD. Comparing LC–ILD to LC–noILD patients, respectively, more were men (85.7% vs. 66.2%; p = 0.02); adenocarcinomas were less frequent (47.1% vs. 58.7%, p = 0.08); median [range] and overall survival was shorter: (9 [range: 0.1–39.4] vs. 17.5 [range: 0.8–50.4] months; p = 0.01). Multivariate analysis (hazard ratio [95% confidence interval]) retained two factors independently associated with LC risk of death: ILD (1.79 [1.22–2.62]; p = 0.003) and standard-of-care management (0.49 [0.33–0.72]; p < 0.001). Approximately 5% of patients with a new LC diagnosis had associated ILD. ILD was a major prognosis factor for LC and should be taken into consideration for LC management. Further studies are needed to determine the best therapeutic strategy for the LC–ILD population.

show abstract

Stereotactic Body Radiation Therapy for Patients with Pulmonary Interstitial Change: High Incidence of Fatal Radiation Pneumonitis in a Retrospective Multi-Institutional Study

Cited by 36 publications

References 18 publications

Risk factors for radiation pneumonitis in lung cancer patients with subclinical interstitial lung disease after thoracic radiation therapy

Risk factors for radiation pneumonitis in lung cancer patients with subclinical interstitial lung disease after thoracic radiation therapy

Risk Factors for Radiation Pneumonitis in Lung Cancer Patients with Subclinical Interstitial Lung Disease after Thoracic Radiation Therapy

Interstitial Lung Disease Associated with Lung Cancer: A Case–Control Study

Contact Info

Product

Resources

About