PURPOSE: To identify clinical risk factors and dose-volume thresholds for treatment-related pneumonitis (TRP) in patients with non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Data were retrospectively collected from patients with inoperable NSCLC treated with radiotherapy with or without chemotherapy. TRP was graded according to Common Terminology Criteria for Adverse Events, version 3.0, with time to grade > or = 3 TRP calculated from start of radiotherapy. Clinical factors and dose-volume parameters were analyzed for their association with risk of TRP. RESULTS: Data from 576 patients (75% with stage III NSCLC) were included in this study. The Kaplan-Meier estimate of the incidence of grade > or = 3 TRP at 12 months was 22%. An analysis of dose-volume parameters identified a threshold dose-volume histogram (DVH) curve defined by V(20) < or = 25%, V(25) < or = 20%, V(35) < or = 15%, and V(50) < or = 10%. Patients with lung DVHs satisfying these constraints had only 2% incidence of grade > or = 3 TRP. Smoking status was the only clinical factor that affected the risk of TRP independent of dosimetric factors. CONCLUSIONS: The risk of TRP varied significantly, depending on radiation dose-volume parameters and patient smoking status. Further studies are needed to identify biological basis of smoking effect and methods to reduce the incidence of TRP.
PURPOSE: To identify clinical risk factors and dose-volume thresholds for treatment-related pneumonitis (TRP) in patients with non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Data were retrospectively collected from patients with inoperable NSCLC treated with radiotherapy with or without chemotherapy. TRP was graded according to Common Terminology Criteria for Adverse Events, version 3.0, with time to grade > or = 3 TRP calculated from start of radiotherapy. Clinical factors and dose-volume parameters were analyzed for their association with risk of TRP. RESULTS: Data from 576 patients (75% with stage III NSCLC) were included in this study. The Kaplan-Meier estimate of the incidence of grade > or = 3 TRP at 12 months was 22%. An analysis of dose-volume parameters identified a threshold dose-volume histogram (DVH) curve defined by V(20) < or = 25%, V(25) < or = 20%, V(35) < or = 15%, and V(50) < or = 10%. Patients with lung DVHs satisfying these constraints had only 2% incidence of grade > or = 3 TRP. Smoking status was the only clinical factor that affected the risk of TRP independent of dosimetric factors. CONCLUSIONS: The risk of TRP varied significantly, depending on radiation dose-volume parameters and patient smoking status. Further studies are needed to identify biological basis of smoking effect and methods to reduce the incidence of TRP.
Authors: Ellen D Yorke; Andrew Jackson; Kenneth E Rosenzweig; Scott A Merrick; Dorota Gabrys; Ennapadam S Venkatraman; Chandra M Burman; Steven A Leibel; C Clifton Ling Journal: Int J Radiat Oncol Biol Phys Date: 2002-10-01 Impact factor: 7.038
Authors: Shu-lian Wang; Zhongxing Liao; Ara A Vaporciyan; Susan L Tucker; Helen Liu; Xiong Wei; Stephen Swisher; Jaffer A Ajani; James D Cox; Ritsuko Komaki Journal: Int J Radiat Oncol Biol Phys Date: 2005-10-19 Impact factor: 7.038
Authors: Shulian Wang; Zhongxing Liao; Xiong Wei; H Helen Liu; Susan L Tucker; Chaosu Hu; Jaffer A Ajani; Alexandria Phan; Stephen G Swisher; Radhe Mohan; James D Cox; Ritsuko Komaki Journal: J Thorac Oncol Date: 2008-03 Impact factor: 15.609
Authors: D Oetzel; P Schraube; F Hensley; G Sroka-Pérez; M Menke; M Flentje Journal: Int J Radiat Oncol Biol Phys Date: 1995-09-30 Impact factor: 7.038
Authors: Gilda G Hillman; Vinita Singh-Gupta; Lindsay Runyan; Christopher K Yunker; Joseph T Rakowski; Fazlul H Sarkar; Steven Miller; Shirish M Gadgeel; Seema Sethi; Michael C Joiner; Andre A Konski Journal: Radiother Oncol Date: 2011-11-11 Impact factor: 6.280
Authors: Gilda G Hillman; Vinita Singh-Gupta; David J Hoogstra; Lisa Abernathy; Joseph Rakowski; Christopher K Yunker; Shoshana E Rothstein; Fazlul H Sarkar; Shirish Gadgeel; Andre A Konski; Fulvio Lonardo; Michael C Joiner Journal: Radiother Oncol Date: 2013-09-07 Impact factor: 6.280
Authors: Zhongxing Liao; J Jack Lee; Ritsuko Komaki; Daniel R Gomez; Michael S O'Reilly; Frank V Fossella; George R Blumenschein; John V Heymach; Ara A Vaporciyan; Stephen G Swisher; Pamela K Allen; Noah Chan Choi; Thomas F DeLaney; Stephen M Hahn; James D Cox; Charles S Lu; Radhe Mohan Journal: J Clin Oncol Date: 2018-01-02 Impact factor: 44.544
Authors: Tejan P Diwanji; Pranshu Mohindra; Melissa Vyfhuis; James W Snider; Chaitanya Kalavagunta; Sina Mossahebi; Jen Yu; Steven Feigenberg; Shahed N Badiyan Journal: Transl Lung Cancer Res Date: 2017-04
Authors: Yevgeniy Vinogradskiy; Richard Castillo; Edward Castillo; Susan L Tucker; Zhongxing Liao; Thomas Guerrero; Mary K Martel Journal: Int J Radiat Oncol Biol Phys Date: 2013-03-06 Impact factor: 7.038
Authors: Susan L Tucker; H Helen Liu; Zhongxing Liao; Xiong Wei; Shulian Wang; Hekun Jin; Ritsuko Komaki; Mary K Martel; Radhe Mohan Journal: Int J Radiat Oncol Biol Phys Date: 2008-10-01 Impact factor: 7.038