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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 1/2015

01-02-2015 | Original Article

Radiotherapy for thoracic tumors: association between subclinical interstitial lung disease and fatal radiation pneumonitis

Authors: Shinsaku Yamaguchi, Takayuki Ohguri, Yuichi Matsuki, Katsuya Yahara, Hodaka Oki, Hajime Imada, Hiroyuki Narisada, Yukunori Korogi

Published in: International Journal of Clinical Oncology | Issue 1/2015

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Abstract

Background

We evaluated the association between subclinical interstitial lung disease (ILD) and fatal radiation pneumonitis (RP) in patients with thoracic tumors treated with thoracic radiotherapy (RT).

Methods

Sixty-two consecutive patients with thoracic tumors treated with thoracic RT were retrospectively analyzed. According to our protocols, patients with subclinical ILD (untreated and asymptomatic) were considered to be indicated for thoracic RT, while patients with clinical ILD (post- or during treatment) were not considered candidates for thoracic RT. The presence, extent and distribution of subclinical ILD on CT findings at pre-thoracic RT were reviewed and scored by two chest radiologists. The relationships between RP and clinical factors, including subclinical ILD, were investigated.

Results

Subclinical ILD was recognized in 11 (18 %) of the 62 patients. Grade 2–5 RP was recognized in eight (13 %) of the 62 patients, with Grade 5 in three patients and Grade 2 in five patients. Grade 2–5 RP was observed in four (36 %) of the 11 patients with subclinical ILD. Subclinical ILD was found to be a significant factor influencing the development of Grade 2–5 RP (p = 0.0274). Subclinical ILD tended to be significant for the occurrence of Grade 5 RP (p = 0.0785). Regarding the CT score, more extensive ILD (bilateral fibrosis in multiple lobes) was recognized in two of the three patients with Grade 5 RP.

Conclusions

In this study, fatal RP tended to be more common in the patients with subclinical ILD. In particular, the presence of extensive fibrosis on CT may be a contraindication for thoracic RT.
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Metadata
Title
Radiotherapy for thoracic tumors: association between subclinical interstitial lung disease and fatal radiation pneumonitis
Authors
Shinsaku Yamaguchi
Takayuki Ohguri
Yuichi Matsuki
Katsuya Yahara
Hodaka Oki
Hajime Imada
Hiroyuki Narisada
Yukunori Korogi
Publication date
01-02-2015
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 1/2015
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-014-0679-1

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