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01-06-2020 | NSCLC | Original Article

Acute severe radiation pneumonitis among non-small cell lung cancer (NSCLC) patients with moderate pulmonary dysfunction receiving definitive concurrent chemoradiotherapy: Impact of pre-treatment pulmonary function parameters

Authors: Ying Zhou, Tiansheng Yan, Xiaojuan Zhou, Peng Cao, Chunli Luo, Lin Zhou, Yong Xu, Yongmei Liu, Jianxin Xue, Jin Wang, Yongsheng Wang, You Lu, Binmiao Liang, Youling Gong, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 6/2020

Abstract

Purpose

Severe acute radiation pneumonitis (SARP) is a life-threatening complication of thoracic radiotherapy. Pre-treatment pulmonary function (PF) may influence its incidence. We have previously reported on the incidence of SARP among patients with moderate pulmonary dysfunction who received definitive concurrent chemoradiotherapy (dCCRT) for non-small cell lung cancer (NSCLC).

Methods

The clinical outcomes, dose–volume histograms (DVH), and PF parameters of 122 patients (forced expiratory volume in 1 s [FEV1%]: 60–69%) receiving dCCRT between 2013 and 2019 were recorded. SARP was defined as grade ≥3 RP occurring during or within 3 months after CCRT. Logistic regression, receiver operating characteristics curves (ROC), and hazard ratio (HR) analyses were performed to evaluate the predictive value of each factor for SARP.

Results

Univariate and multivariate analysis indicated that the ratio of carbon monoxide diffusing capacity (DLCO%; odds ratio [OR]: 0.934, 95% confidence interval [CI] 0.896–0.974, p = 0.001) and mean lung dose (MLD; OR: 1.002, 95% CI 1.001–1.003, p = 0.002) were independent predictors of SARP. The ROC AUC of combined DLCO%/MLD was 0.775 (95% confidence interval [CI]: 0.688–0.861, p = 0.001), with a sensitivity and specificity of 0.871 and 0.637, respectively; this was superior to DLCO% (0.656) or MLD (0.667) alone. Compared to the MLD-low/DLCO%-high group, the MLD-high/DLCO%-low group had the highest risk for SARP, with an HR of 9.346 (95% CI: 2.133–40.941, p = 0.003).

Conclusion

The DLCO% and MLD may predict the risk for SARP among patients with pre-treatment moderate pulmonary dysfunction who receive dCCRT for NSCLC. Prospective studies are needed to validate our findings.

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Title: Acute severe radiation pneumonitis among non-small cell lung cancer (NSCLC) patients with moderate pulmonary dysfunction receiving definitive concurrent chemoradiotherapy: Impact of pre-treatment pulmonary function parameters
Authors: Ying Zhou
Tiansheng Yan
Xiaojuan Zhou
Peng Cao
Chunli Luo
Lin Zhou
Yong Xu
Yongmei Liu
Jianxin Xue
Jin Wang
Yongsheng Wang
You Lu
Binmiao Liang
Youling Gong, MD, PhD
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: NSCLC
NSCLC
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 6/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-019-01552-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute severe radiation pneumonitis among non-small cell lung cancer (NSCLC) patients with moderate pulmonary dysfunction receiving definitive concurrent chemoradiotherapy: Impact of pre-treatment pulmonary function parameters

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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