TY - JOUR
T1 - Prognostic Value of Radiation Pneumonitis After Stereotactic Body Radiotherapy
T2 - Effect of Pulmonary Emphysema Quantitated Using CT Images
AU - Yamamoto, Takaya
AU - Kadoya, Noriyuki
AU - Sato, Yoshinao
AU - Matsushita, Haruo
AU - Umezawa, Rei
AU - Kubozono, Masaki
AU - Ishikawa, Yojiro
AU - Kozumi, Maiko
AU - Takahashi, Noriyoshi
AU - Morishita, Yohei
AU - Katagiri, Yu
AU - Sato, Kiyokazu
AU - Ito, Kengo
AU - Takeda, Ken
AU - Jingu, Keiichi
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/1
Y1 - 2018/1
N2 - The prognostic role of pulmonary emphysema for radiation pneumonitis (RP) after stereotactic body radiotherapy was investigated. It is true that patients with pulmonary emphysema showed a lower rate of abnormal shadow, but there was no association with Grade 2 to 3 RP. This is because patients with pulmonary emphysema had a low tolerance for symptomatic RP because of poor pulmonary function. Background: The aim of this study was to determine the prognostic factors of radiation pneumonitis (RP) after stereotactic body radiotherapy (SBRT). Patients and Methods: A total of 50 patients (36 male and 14 female) were treated with SBRT for 42 primary lung cancers and 8 metastatic lung cancers. SBRT was performed with 48 Gy in 4 fractions to the isocenter or with 40 Gy in 4 fractions covering 95% of the planning target volume. Percentage of low attenuation area (%LAA) was defined as percentage of the lung area with attenuation of −860 Hounsfield units (HU) or lower (%LAA-860) or of −960 HU or lower (%LAA-960). The dosimetric parameter of V 20 Gy , which means percentage volume of the lung receiving 20 Gy or more, was recalculated. RP was assessed using Common Terminology Criteria for Adverse Events version 4.0. Results: The median follow-up period was 39.0 months (range, 7.2-94.5 months). RP of Grade 0, Grade 1, and Grade 2 to 3 was diagnosed in 11, 29, and 10 patients, respectively. Multivariate analyses (MVA) for Grade 1 showed that higher %LAA-860 and higher %LAA-960 were significantly associated with a lower rate of Grade 1 RP. MVA for Grade 2 to 3 showed that lower Brinkman index and lower lung V 20 Gy were significantly associated with a lower rate of Grade 2 to 3 RP, and, in contrast, %LAA-860 and %LAA-960 had no association with Grade 2 to 3 RP. Conclusion: This result suggests that high %LAA is associated with radiological changes (Grade 1) but that %LAA has no correlation with Grade 2 to 3 RP because symptomatic RP might also be affected by other factors.
AB - The prognostic role of pulmonary emphysema for radiation pneumonitis (RP) after stereotactic body radiotherapy was investigated. It is true that patients with pulmonary emphysema showed a lower rate of abnormal shadow, but there was no association with Grade 2 to 3 RP. This is because patients with pulmonary emphysema had a low tolerance for symptomatic RP because of poor pulmonary function. Background: The aim of this study was to determine the prognostic factors of radiation pneumonitis (RP) after stereotactic body radiotherapy (SBRT). Patients and Methods: A total of 50 patients (36 male and 14 female) were treated with SBRT for 42 primary lung cancers and 8 metastatic lung cancers. SBRT was performed with 48 Gy in 4 fractions to the isocenter or with 40 Gy in 4 fractions covering 95% of the planning target volume. Percentage of low attenuation area (%LAA) was defined as percentage of the lung area with attenuation of −860 Hounsfield units (HU) or lower (%LAA-860) or of −960 HU or lower (%LAA-960). The dosimetric parameter of V 20 Gy , which means percentage volume of the lung receiving 20 Gy or more, was recalculated. RP was assessed using Common Terminology Criteria for Adverse Events version 4.0. Results: The median follow-up period was 39.0 months (range, 7.2-94.5 months). RP of Grade 0, Grade 1, and Grade 2 to 3 was diagnosed in 11, 29, and 10 patients, respectively. Multivariate analyses (MVA) for Grade 1 showed that higher %LAA-860 and higher %LAA-960 were significantly associated with a lower rate of Grade 1 RP. MVA for Grade 2 to 3 showed that lower Brinkman index and lower lung V 20 Gy were significantly associated with a lower rate of Grade 2 to 3 RP, and, in contrast, %LAA-860 and %LAA-960 had no association with Grade 2 to 3 RP. Conclusion: This result suggests that high %LAA is associated with radiological changes (Grade 1) but that %LAA has no correlation with Grade 2 to 3 RP because symptomatic RP might also be affected by other factors.
KW - %LAA
KW - Low attenuation area
KW - Predictive factor
KW - Radiation-induced lung toxicity
KW - SBRT
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UR - http://www.scopus.com/inward/citedby.url?scp=85021112477&partnerID=8YFLogxK
U2 - 10.1016/j.cllc.2017.05.022
DO - 10.1016/j.cllc.2017.05.022
M3 - Article
C2 - 28655592
AN - SCOPUS:85021112477
SN - 1525-7304
VL - 19
SP - e85-e90
JO - Clinical Lung Cancer
JF - Clinical Lung Cancer
IS - 1
ER -
