DOSE-VOLUME ANALYSIS OF RADIATION PNEUMONITIS IN NON-SMALL-CELL LUNG CANCER PATIENTS TREATED WITH CONCURRENT CISPLATINUM AND ETOPOSIDE WITH OR WITHOUT CONSOLIDATION DOCETAXEL
DOSE-VOLUME ANALYSIS OF RADIATION PNEUMONITIS IN NON-SMALL-CELL LUNG CANCER PATIENTS TREATED WITH CONCURRENT CISPLATINUM AND ETOPOSIDE WITH OR WITHOUT CONSOLIDATION DOCETAXEL
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DOI：
10.1016/j.ijrobp.2009.09.030
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发表时间：
2010-12-01
影响因子：
7
通讯作者：
McGarry, Ronald C.
中科院分区：
文献类型：
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作者：
Barriger, R. Bryan;Fakiris, Achilles J.;McGarry, Ronald C.
目的探讨非小细胞肺癌(NSCLC)放化疗患者放射性肺炎(RP)的发生率和危险因素。方法与资料：我们回顾了接受前瞻性随机试验的HI期非小细胞肺癌(NSCLC)患者的剂量学记录。接受顺铂/依托泊苷联合放射治疗的患者共243例，167例没有进展，随机分为观察(OB)或巩固(OB)或巩固多西紫杉醇(CD)，使用通用的毒性和不良事件(CTCAE)V3标准对其毒性进行编码。结果中位年龄63岁，随访16个月。0~1级和2~5级分别为226例和17例(7%)，可评价患者的平均肺剂量(MLD)0~1级分别为18、52%、35%和29%，2~5级分别为1,748和2,013 cGy(P=0.12)。0~1级组和2~5级组平均V20分别为33.7%和37.7%(P=0.29)，2~5级分别为4.8%和17%。0~1级和2~5级RP患者的平均V5、V10、V15、V20、V25、V30、年龄、吸烟史和肿瘤特征相似。结论本研究中接受放化疗的患者中，2~5级RP的总发生率为7%，预测因素为MLD和GT；18GY和CD(C)2010治疗。
Purpose To examine the rates and risk factors for radiation pneumonitis (RP) in non small-cell lung cancer (NSCLC) patients treated with chemoradiotherapyMethods and Materials We reviewed dosimetry records from Stage HI NSCLC patients treated on a prospective randomized trial Patients received concurrent cisplatinum/etoposide with radiation therapy to 59 4Gy A total of 243 patients were enrolled, 167 did not experience progression and were randomized to observation (OB) or con solidation docetaxel (CD) Toxicity was coded based on the presence of Grade 0 to 1 vs Grade 2 to 5 RP using the Common Toxicity Criteria and Adverse Events (CTCAE) v3 0Results Median age and follow up were 63 years and 16 months, respectively Overall, Grade 0 to 1 and Grade 2 to 5 RP were reported in 226 patients and 17 patients (7%) respectively Median mean lung dose (MLD), V5, V20, and V30 for evaluable patients were 18 Gy, 52%, 35%, and 29% MLD in Grade 0 to 1 and Grade 2 to 5 patients was 1,748 c Gy and 2,013 cGy in respectively (p = 0 12) Grade 2 to 5 RP developed in 2 2% and 19% of patients with MLD < 18 Gy and MLD > 18 Gy, respectively (p = 0 015) Mean V20 was 33 7% and 37 7% for Grade 0 to 1 and Grade 2 to 5 groups, respectively (p = 0 29) Grade 2 to 5 RP developed in 4 8% and 17% of patients with V20 < 35% and V20 > 35%, respectively The OB and CD groups had similar MLD and V20, and the RP rates were 3 6% and 14 6%, respectively (p = 0 015) Patients who developed Grade 0 to 1 and Grade 2 to 5 RP had similar mean V5, V10, V15, V20, V25, V30, age, smoking history, and tumor characteristicsConclusions The overall rate of Grade 2 to 5 RP was 7% in patients treated with chemoradiotherapy In this analysis, predictive factors for RP were MLD > 18 Gy and treatment with CD (C) 2010 Elsevier Inc