Dose-volume factors predicting radiation pneumonitis in patients receiving salvage radiotherapy for postlobectomy locoregional recurrent non-small-cell lung cancer.
Dose-volume factors predicting radiation pneumonitis in patients receiving salvage radiotherapy for postlobectomy locoregional recurrent non-small-cell lung cancer.
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DOI：
10.1007/s10147-005-0542-5
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发表时间：
2006-02-01
影响因子：
3.3
通讯作者：
Ito, Hisao
中科院分区：
文献类型：
--
作者：
Uno, Takashi;Isobe, Koichi;Ito, Hisao
背景技术背景：治疗相关因素和肺毒性之间的相关性尚未得到充分评价挽救radiotherapy.METHODS：21例肺叶切除术后复发的非小细胞肺癌（NSCLC）患者接受挽救放疗，总剂量为46-60戈伊。结果：放射性肺炎（RP）1级4例，2级2例，3级1例。发生RP的患者的V剂量（V13，V20）参数和平均肺剂量（MLD）值显著高于未发生RP的患者。关于G2或更高RP，3例发生>或= G2 RP的患者的V20、V13和MLD值显著高于其余患者，P值分别为0.01、0.015和0.016。这3例患者的平均V20、V13和MLD分别为27%、29.3%和14.8戈伊，而其余18例患者的平均V20、V13和MLD分别为15.8%、18.3%和8.8戈伊。V20 ≥ 20%的6例患者中有3例发生≥ G2 RP，而其余患者未发生（P = 0.015）。同样，6例V13 ≥ 23%的患者中有3例发生≥ G2 RP，而其余患者未发生（P = 0.015）。结论：这些数据表明，与确定性放疗相比，较低的V剂量值或MLD可能是复发性NSCLC患者接受挽救性放疗时RP的替代品。
BACKGROUND: The correlation between treatment-related factors and lung toxicity has not been sufficiently evaluated in salvage radiotherapy.METHODS: Twenty-one patients with recurrent non-small-cell lung cancer (NSCLC) after lobectomy received salvage radiotherapy to a total dose of 46-60 Gy. The effects of radiotherapy parameters on the development of radiation pneumonitis (RP) were examined using dose-volume histograms.RESULTS: Grade 1 RP was observed in 4, grade 2 in 2, and grade 3 in 1 patient. Patients who developed RP had a significantly higher value in V dose (V13, V20) parameters and mean lung dose (MLD) than those who did not develop RP. Concerning G2 or higher RP, 3 patients who developed > or = G2 RP had a significantly higher value in V20, V13, and MLD than the remaining patients with P values of 0.01, 0.015, and 0.016, respectively. The mean V20, V13, and MLD in these 3 patients were 27%, 29.3%, and 14.8 Gy, respectively, whereas the mean V20, V13, and MLD in the remaining 18 patients were 15.8%, 18.3%, and 8.8 Gy, respectively. Three of 6 patients with a V20 > or = 20% developed > or = G2 RP whereas this did not occur in the remaining patients (P = 0.015). Similarly, 3 of 6 patients with a V13 > or = 23% developed > or = G2 RP whereas this did not occur in the remaining patients (P = 0.015).CONCLUSIONS: These data suggest that a somewhat lower V dose value or MLD, as compared with the setting of definitive radiotherapy, could be a surrogate for RP in patients undergoing salvage radiotherapy for recurrent NSCLC.