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Ogata, Takeshi Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
Katsui, Kuniaki Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
Yoshio, Kotaro Department of Radiology, Kagawa Prefectural Central Hospital
Ihara, Hiroki Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
Katayama, Norihisa Department of Radiology, Okayama University Hospital
Soh, Junichi Department of General Thoracic Surgery, Okayama University Hospital
Kuroda, Masahiro Department of Radiological Technology, Graduate School of Health Sciences, Okayama University
Kiura, Katsuyuki Department of Allergy and Respiratory Medicine, Okayama University Hospital
Maeda, Yoshinobu Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
Toyooka, Shinichi Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
Kanazawa, Susumu Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
Abstract
To clarify the relationship between dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) after surgery in cases of non-small cell lung cancer (NSCLC) treated with induction concurrent chemoradiotherapy (CCRT). Patients with NSCLC treated with induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 2.0 Gy fractions once daily for a total of 46 Gy) before surgery were reviewed. We calculated the percentage of lung volume receiving at least 20 Gy (V20) and the mean lung dose (MLD) for the total lung volume and the lung remaining after resection. Factors affecting the incidence of RP at grade 2 or higher (≥ G2 RP) were analyzed. Eighteen of 49 patients (37%) experienced ≥G2 RP. The V20 and MLD for the lung remaining after resection (V20r and MLDr) were significant predictors according to the multivariate analysis (p=0.007 and 0.041, respectively). The incidence of ≥G2 RP was 8% in patients with V20r<10%, and 13% in patients with MLDr<5.6 Gy, respectively. The optimal approach to reduce the rate of postoperative RP in patients with induction CCRT for NSCLC is to keep the V20r below 10% and/or the MLDr below 5.6 Gy in the radiotherapy planning.
Keywords
radiation pneumonitis
V20
mean lung dose
induction chemoradiotherapy
non-small cell lung cancer
Amo Type
Original Article
Published Date
2018-10
Publication Title
Acta Medica Okayama
Volume
volume72
Issue
issue5
Publisher
Okayama University Medical School
Start Page
507
End Page
513
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2018 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID