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01-09-2016 | Original Article

Relationship between dose–volume parameters and pulmonary complications after neoadjuvant chemoradiotherapy followed by surgery for lung cancer

Authors: Shigeo Takahashi, MD, Tetsuhiko Go, MD, PhD, Yoshitaka Kasai, MD, PhD, Hiroyasu Yokomise, MD, PhD, Toru Shibata, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 9/2016

Abstract

Purpose

This study evaluated the relationship between dose–volume histogram (DVH) parameters and pulmonary complications after neoadjuvant chemoradiotherapy (NACRT) followed by surgery for lung cancer. We also examined a new DVH parameter, because the unresected lung should be more spared than the later resected lung.

Patients and methods

Data from 43 non-small cell lung cancer patients were retrospectively analyzed. The DVH parameters of the lung were calculated from the total bilateral lung volume minus (1) the gross tumor volume (DVHg) or (2) the later resected lung volume (DVHr). Radiation pneumonitis (RP) and fistula, including bronchopleural and pulmonary fistula, were graded as the pulmonary complications. Factors affecting the incidences of grade 2 or higher RP (≥G2 RP) and fistula were analyzed.

Results

Sixteen patients (37 %) experienced ≥G2 RP and a V20 value of the total lung minus the later resected lung (V20r) ≥ 12 % was a significant factor affecting the incidence of ≥G2 RP (p = 0.032). Six patients (14 %) developed a fistula and a V35 value of the total lung minus the gross tumor (V35g) ≥ 19 % and a V40g ≥ 16 % were significant factors affecting the incidence of fistula (p = 0.002 and 0.009, respectively).

Conclusion

These DVH parameters may be related to the incidences of ≥G2 RP and fistula.

National Comprehensive Cancer Network Non-small cell lung cancer, NCCN Clinical Practice Guidelines in Oncology: version 7.2015. http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed 07/14/2015

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Title: Relationship between dose–volume parameters and pulmonary complications after neoadjuvant chemoradiotherapy followed by surgery for lung cancer
Authors: Shigeo Takahashi, MD
Tetsuhiko Go, MD, PhD
Yoshitaka Kasai, MD, PhD
Hiroyasu Yokomise, MD, PhD
Toru Shibata, MD, PhD
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 9/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1021-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Relationship between dose–volume parameters and pulmonary complications after neoadjuvant chemoradiotherapy followed by surgery for lung cancer

Abstract

Purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

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