Laura Cella1, Vittoria D'Avino2, Giuseppe Palma2, Manuel Conson3, Raffaele Liuzzi2, Marco Picardi4, Maria Cristina Pressello5, Genoveva Ionela Boboc6, Roberta Battistini7, Vittorio Donato6, Roberto Pacelli3. 1. Institute of Biostructure and Bioimaging, National Research Council (CNR), Naples, Italy. Electronic address: laura.cella@cnr.it. 2. Institute of Biostructure and Bioimaging, National Research Council (CNR), Naples, Italy. 3. Institute of Biostructure and Bioimaging, National Research Council (CNR), Naples, Italy; Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy. 4. Department of Clinical Medicine and Surgery, Federico II University School of Medicine, Naples, Italy. 5. Department of Health Physics, S. Camillo-Forlanini Hospital, Rome, Italy. 6. Department of Radiation Oncology, S. Camillo-Forlanini Hospital, Rome, Italy. 7. Department of Hematology, S. Camillo-Forlanini Hospital, Rome, Italy.
Abstract
PURPOSE: We used normal tissue complication probability (NTCP) modeling to explore the impact of heart irradiation on radiation-induced lung fibrosis (RILF). MATERIALS AND METHODS: We retrospectively reviewed for RILF 148 consecutive Hodgkin lymphoma (HL) patients treated with sequential chemo-radiotherapy (CHT-RT). Left, right, total lung and heart dose-volume and dose-mass parameters along with clinical, disease and treatment-related characteristics were analyzed. NTCP modeling by multivariate logistic regression analysis using bootstrapping was performed. Models were evaluated by Spearman Rs coefficient and ROC area. RESULTS: At a median time of 13months, 18 out of 115 analyzable patients (15.6%) developed RILF after treatment. A three-variable predictive model resulted to be optimal for RILF. The two models most frequently selected by bootstrap included increasing age and mass of heart receiving >30Gy as common predictors, in combination with left lung V5 (Rs=0.35, AUC=0.78), or alternatively, the lungs near maximum dose D2% (Rs=0.38, AUC=0.80). CONCLUSION: CHT-RT may cause lung injury in a small, but significant fraction of HL patients. Our results suggest that aging along with both heart and lung irradiation plays a fundamental role in the risk of developing RILF.
PURPOSE: We used normal tissue complication probability (NTCP) modeling to explore the impact of heart irradiation on radiation-induced lung fibrosis (RILF). MATERIALS AND METHODS: We retrospectively reviewed for RILF 148 consecutive Hodgkin lymphoma (HL) patients treated with sequential chemo-radiotherapy (CHT-RT). Left, right, total lung and heart dose-volume and dose-mass parameters along with clinical, disease and treatment-related characteristics were analyzed. NTCP modeling by multivariate logistic regression analysis using bootstrapping was performed. Models were evaluated by Spearman Rs coefficient and ROC area. RESULTS: At a median time of 13months, 18 out of 115 analyzable patients (15.6%) developed RILF after treatment. A three-variable predictive model resulted to be optimal for RILF. The two models most frequently selected by bootstrap included increasing age and mass of heart receiving >30Gy as common predictors, in combination with left lung V5 (Rs=0.35, AUC=0.78), or alternatively, the lungs near maximum dose D2% (Rs=0.38, AUC=0.80). CONCLUSION: CHT-RT may cause lung injury in a small, but significant fraction of HLpatients. Our results suggest that aging along with both heart and lung irradiation plays a fundamental role in the risk of developing RILF.
Authors: Chelsea C Pinnix; Laura Cella; Therese Y Andraos; Zeina Ayoub; Sarah A Milgrom; Jillian Gunther; Sonali Thosani; Christine Wogan; Manuel Conson; Vittoria D'Avino; Yasuhiro Oki; Michelle Fanale; Hun J Lee; Sattva Neelapu; Luis Fayad; Frederick Hagemeister; M Alma Rodriguez; Loretta J Nastoupil; Yago Nieto; Wei Qiao; Roberto Pacelli; Bouthaina Dabaja Journal: Int J Radiat Oncol Biol Phys Date: 2018-03-14 Impact factor: 7.038
Authors: D Alterio; M A Gerardi; L Cella; R Spoto; V Zurlo; A Sabbatini; C Fodor; V D'Avino; M Conson; F Valoriani; D Ciardo; R Pacelli; A Ferrari; P Maisonneuve; L Preda; R Bruschini; M Cossu Rocca; E Rondi; S Colangione; G Palma; S Dicuonzo; R Orecchia; G Sanguineti; B A Jereczek-Fossa Journal: Strahlenther Onkol Date: 2017-09-07 Impact factor: 3.621
Authors: Giuseppe Palma; Serena Monti; Vittoria D'Avino; Manuel Conson; Raffaele Liuzzi; Maria Cristina Pressello; Vittorio Donato; Joseph O Deasy; Mario Quarantelli; Roberto Pacelli; Laura Cella Journal: Int J Radiat Oncol Biol Phys Date: 2016-05-07 Impact factor: 7.038
Authors: A Franco; M Ciccarelli; D Sorriento; L Napolitano; A Fiordelisi; B Trimarco; M Durante; G Iaccarino Journal: Transl Med UniSa Date: 2016-05-16