start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=1 article-no= start-page=1144 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201911 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND:
The relationship between lung dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) associated with induction concurrent chemoradiotherapy (CCRT) followed by surgery in patients with non-small cell lung cancer (NSCLC) is unclear, particularly when concerning irradiation of the whole lung prior to resection. We performed this study to identify factors associated with grade???2 RP in such patients.
METHODS:
Patients who received induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 46?Gy/23 fractions) between May 2003 and May 2017 were reviewed. The mean lung dose (MLD) and the percentage of the lung volume that received ?5?Gy (V5) and???20?Gy (V20) were calculated. Factors associated with the development of grade???2 RP were analyzed.
RESULTS:
One hundred and eight patients were included in this study, 34 (31.5%) of whom experienced grade???2 RP. A V20???21%, an MLD ?10?Gy, and a lower lobe tumor location were significant predictors of grade???2 RP on univariate analysis (p?=?0.007, 0.002, and 0.004, respectively). Moreover, an MLD ?10?Gy and lower lobe location were significant predictors of grade???2 RP on multivariate analysis (p?=?0.026 and 0.0043, respectively). The cumulative incidence rates of grade???2 RP at 6?months were 15.7 and 45.6% in patients with MLDs CONCLUSIONS:
MLD and lower lobe location were predictors of grade???2 RP in patients who received induction CCRT. It is necessary to reduce the MLD to the greatest extent possible to prevent the occurrence of this adverse event. en-copyright= kn-copyright= en-aut-name=KatsuiKuniaki en-aut-sei=Katsui en-aut-mei=Kuniaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OgataTakeshi en-aut-sei=Ogata en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WatanabeKenta en-aut-sei=Watanabe en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KatayamaNorihisa en-aut-sei=Katayama en-aut-mei=Norihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SohJunichi en-aut-sei=Soh en-aut-mei=Junichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KurodaMasahiro en-aut-sei=Kuroda en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KiuraKatsuyuki en-aut-sei=Kiura en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MaedaYoshinobu en-aut-sei=Maeda en-aut-mei=Yoshinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ToyookaShinichi en-aut-sei=Toyooka en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KanazawaSusumu en-aut-sei=Kanazawa en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science kn-affil= affil-num=2 en-affil=Department of Radiology, Iwakuni Clinical Center kn-affil= affil-num=3 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=5 en-affil=Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine kn-affil= affil-num=6 en-affil=Department of Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Allergy and Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=8 en-affil=Hematology, Oncology and Respiratory Medicine kn-affil= affil-num=9 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological SurgeryOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science kn-affil= en-keyword=Induction chemoradiotherapy kn-keyword=Induction chemoradiotherapy en-keyword=Lower lobe kn-keyword=Lower lobe en-keyword=Mean lung dose kn-keyword=Mean lung dose en-keyword=Non-small cell lung cancer kn-keyword=Non-small cell lung cancer en-keyword=Radiation pneumonitis kn-keyword=Radiation pneumonitis END