Analysis of risk factors of radiation-induced lung toxicity in non-small cell lung cancer patients treated with postoperative radiotherapy
10.3760/cma.j.issn.1004-4221.2019.10.004
- VernacularTitle: 非小细胞肺癌术后放疗相关肺毒性风险因素分析
- Author:
Chengcheng FAN
1
,
2
;
Lujun ZHAO
1
,
3
;
Nan BI
1
;
Zhouguang HUI
1
;
Jun LIANG
1
;
Jima LYU
1
;
Xiaozhen WANG
1
;
Hong GE
4
;
Luhua WANG
1
Author Information
1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China
2. Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
3. Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
4. Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
- Publication Type:Journal Article
- Keywords:
Lung neoplasm/surgery;
Lung neoplasm/radiotherapy;
Radiation-induced lung injury
- From:
Chinese Journal of Radiation Oncology
2019;28(10):735-740
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the incidence and risk factors of symptomatic radiation-induced lung toxicity (SRILT) in non-small cell lung cancer (NSCLC) patients treated with modern radiotherapy after surgery.
Methods:Clinical data of consecutive NSCLC patients treated with postoperative three-dimensional conformal or intensity-modulated radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences between November 2002 and December 2011 were retrospectively analyzed. According to the Common Terminology Criteria for Adverse Events (CTCAE, version 3.0), SRILT was defined as ≥grade 2 radiation-induced lung toxicity. Potential clinical risk factors and dosimetric parameters for SRILT were evaluated using logistic regression model.
Results:Among 227 enrolled patients, 190 cases underwent lobectomy and 37 patients received pneumonectomy. Twenty-three patients (10.1%) developed SRILT after lobectomy. Seventeen patients experienced grade 2 SRILT, 5 cases of grade 3 SRILT and 1 case of grade 4 SRILT. Univariate analysis showed that postoperative concurrent chemoradiotherapy, relatively large PTV, mean lung dose and V20- V40 were significantly correlated with the incidence of SRILT (P=0.015, 0.048 and<0.001). Multivariate analysis demonstrated that postoperative concurrent chemoradiotherapy and V20 were significantly associated with the incidence of SRILT (P=0.017 and P=0.009).
Conclusions:The incidence of SRILT is relatively low in NSCLC patients after postoperative radiotherapy. Concurrent chemoradiotherapy and V20 are risk factors of SRILT.
