Dosimetric analysis of radiation pneumonitis induced by 125I seed implantation for the treatment of malignant lung tumors
10.3760/cma.j.cn112271-20230511-00142
- VernacularTitle:125I粒子治疗恶性肺肿瘤所致放射性肺炎剂量学因素分析
- Author:
Ke XU
1
;
Jinxin ZHAO
;
Zezhou LIU
;
Yansong LIANG
;
Guohui CAO
;
Xiaoli LIU
;
Yan DI
;
Juan WANG
;
Hongtao ZHANG
Author Information
1. 河北省肿瘤放射性粒子植入诊疗中心 河北省放射性粒子近距离治疗研究所 河北省人民医院肿瘤一科，石家庄 050051
- Keywords:
Radiation pneumonitis;
Lung tumor;
Brachytherapy;
Dosimetric parameter
- From:
Chinese Journal of Radiological Medicine and Protection
2024;44(1):13-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence of radiation pneumonitis (RP) induced by 125I seed implantation for the treatment of malignant lung tumors and analyze related dosimetric parameters. Methods:A retrospective analysis was conducted on 31 cases of malignant lung tumors treated with 125I seed implantation from January 2017 to December 2022 at Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center. These cases consisted of eight patients with squamous cell carcinoma, 10 patients with adenocarcinoma, and 13 patients with metastatic cancer in other sites. At 1-6 months after treatment, these patients received postoperative chest CT scans, with the efficacy evaluated based on the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), including the objective response rate (ORR) and the disease control rate (DCR). The efficacy of RP was evaluated using the Radiation Therapy Oncology Group (RTOG) criteria. Postoperative dosimetric parameters, including D90 (minimum peripheral dose received by 90% of the target volume), V8 (percentage of lung volume receiving 8 Gy), V32 (percentage of lung volume receiving 32 Gy), and Dmean (mean radiation dose) of the affected lung, were statistically analyzed. The relationships of the RP occurrence with postoperative D90, V8, V32, and Dmean were analyzed by comparison with relevant external radiotherapy data, to identify the parameters that are correlated closely with RP occurrence. Results:All the patients underwent successful surgeries. The postoperative efficacy evaluation after six months showed complete response (CR) in 11 cases, partial response (PR) in 11 cases, stable disease (SD) in eight cases, and progressive disease (PD) in one case, with an overall response rate (ORR) of 71.0%, and a disease control rate (DCR) of 96.8%. Three patients suffered RP, with an incidence rate of 9.7%. Postoperative V8, V32, and Dmean could not serve as predictive indicators for RP. Follow-up observation revealed that three RP cases (3/5) exhibited postoperative D90 exceeding 170 Gy and no RP cases (0/26) showed postoperative D90 below 170 Gy. Conclusions:In the treatment of malignant lung tumors with 125I seed implantation, there is a certain correlation between RP and postoperative D90, while there is no correlation between it and V8, V32, and Dmean.
