ID | 57723 |
フルテキストURL | |
著者 |
Katsui, Kuniaki
Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
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Ogata, Takeshi
Department of Radiology, Iwakuni Clinical Center
Watanabe, Kenta
Department of Radiology, Okayama University Hospital
Soh, Junichi
Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine
Kuroda, Masahiro
Department of Radiological Technology, Graduate School of Health Sciences, Okayama University
Kiura, Katsuyuki
Department of Allergy and Respiratory Medicine, Okayama University Hospital
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Maeda, Yoshinobu
Hematology, Oncology and Respiratory Medicine
Toyooka, Shinichi
Department of General Thoracic Surgery and Breast and Endocrinological SurgeryOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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抄録 | 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 < 10 Gy and ≥ 10 Gy, respectively, and were 23.5 and 55.6% in patients with upper/middle lobe- vs. lower lobe-located tumors, respectively. 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. |
キーワード | Induction chemoradiotherapy
Lower lobe
Mean lung dose
Non-small cell lung cancer
Radiation pneumonitis
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発行日 | 2019-11
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出版物タイトル |
BMC Cancer
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巻 | 19巻
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号 | 1号
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出版者 | BMC
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開始ページ | 1144
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ISSN | 1471-2407
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © The Author(s). 2019
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1186/s12885-019-6359-9
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ライセンス | http://creativecommons.org/licenses/by/4.0/
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Citation | Katsui, K., Ogata, T., Watanabe, K. et al. Dose-volume parameters predict radiation pneumonitis after induction chemoradiotherapy followed by surgery for non-small cell lung cancer: a retrospective analysis. BMC Cancer 19, 1144 (2019) doi:10.1186/s12885-019-6359-9
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