Haruki Kobayashi1,2, Kazushige Wakuda3, Tateaki Naito3, Nobuaki Mamesaya3, Shota Omori3, Akira Ono3, Hirotsugu Kenmotsu3, Haruyasu Murakami3, Masahiro Endo4, Hideyuki Harada5, Yasuhiro Gon6, Toshiaki Takahashi3. 1. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. h.kobayashi@scchr.jp. 2. Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan. h.kobayashi@scchr.jp. 3. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 4. Division of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan. 5. Division of Radiation and Proton Therapy, Shizuoka Cancer Center, Shizuoka, Japan. 6. Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan.
Abstract
BACKGROUND: Patients with lung cancer and interstitial lung disease treated with radiotherapy are at risk of developing radiation pneumonitis. However, the association between interstitial lung abnormalities (ILAs) and radiation pneumonitis in patients with limited-stage small-cell lung cancer (LS-SCLC) remains unclear. Furthermore, the prognosis is uncertain for patients with SCLC and ILAs treated with chemoradiotherapy. We investigated the impact of ILAs on radiation pneumonitis and assessed the prognosis of patients with LS-SCLC and ILAs treated with chemoradiotherapy. METHODS: We retrospectively reviewed the medical records of 149 patients with LS-SCLC who received first-line treatment between January 2009 and December 2016. RESULTS: In the univariate analysis, the patients with ILAs showed a higher incidence rate of radiation pneumonitis compared with those without ILAs (64% vs. 10%, P < 0.001). Multivariate analysis confirmed that ILAs were significantly associated with the incidence of radiation pneumonitis. In the univariate analysis, patients with ILAs showed poorer overall survival than those without ILAs (median, 18.9 vs. 67.9 months, P = 0.0338). Multivariate analysis showed that ILAs were a significant independent negative prognostic factor. However, the 2-year and 5-year survival rates for the patients with ILAs treated with chemoradiotherapy were 36% and 26%, respectively, and 8% and 0%, respectively, for those treated with chemotherapy alone. CONCLUSIONS: ILAs were found to be a predictive factor for radiation pneumonitis in patients with LS-SCLC treated with chemoradiotherapy. Patients with LS-SCLC and ILAs who were treated with chemoradiotherapy had both the possibility of long-term survival and risk of radiation pneumonitis.
BACKGROUND:Patients with lung cancer and interstitial lung disease treated with radiotherapy are at risk of developing radiation pneumonitis. However, the association between interstitial lung abnormalities (ILAs) and radiation pneumonitis in patients with limited-stage small-cell lung cancer (LS-SCLC) remains unclear. Furthermore, the prognosis is uncertain for patients with SCLC and ILAs treated with chemoradiotherapy. We investigated the impact of ILAs on radiation pneumonitis and assessed the prognosis of patients with LS-SCLC and ILAs treated with chemoradiotherapy. METHODS: We retrospectively reviewed the medical records of 149 patients with LS-SCLC who received first-line treatment between January 2009 and December 2016. RESULTS: In the univariate analysis, the patients with ILAs showed a higher incidence rate of radiation pneumonitis compared with those without ILAs (64% vs. 10%, P < 0.001). Multivariate analysis confirmed that ILAs were significantly associated with the incidence of radiation pneumonitis. In the univariate analysis, patients with ILAs showed poorer overall survival than those without ILAs (median, 18.9 vs. 67.9 months, P = 0.0338). Multivariate analysis showed that ILAs were a significant independent negative prognostic factor. However, the 2-year and 5-year survival rates for the patients with ILAs treated with chemoradiotherapy were 36% and 26%, respectively, and 8% and 0%, respectively, for those treated with chemotherapy alone. CONCLUSIONS: ILAs were found to be a predictive factor for radiation pneumonitis in patients with LS-SCLC treated with chemoradiotherapy. Patients with LS-SCLC and ILAs who were treated with chemoradiotherapy had both the possibility of long-term survival and risk of radiation pneumonitis.
Authors: J P Pignon; R Arriagada; D C Ihde; D H Johnson; M C Perry; R L Souhami; O Brodin; R A Joss; M S Kies; B Lebeau Journal: N Engl J Med Date: 1992-12-03 Impact factor: 91.245
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Authors: George R Washko; Gary M Hunninghake; Isis E Fernandez; Mizuki Nishino; Yuka Okajima; Tsuneo Yamashiro; James C Ross; Raúl San José Estépar; David A Lynch; John M Brehm; Katherine P Andriole; Alejandro A Diaz; Ramin Khorasani; Katherine D'Aco; Frank C Sciurba; Edwin K Silverman; Hiroto Hatabu; Ivan O Rosas Journal: N Engl J Med Date: 2011-03-10 Impact factor: 91.245