Functional and biologic metrics for predicting radiation pneumonitis in locally advanced non-small cell lung cancer patients treated with chemoradiotherapy
Functional and biologic metrics for predicting radiation pneumonitis in locally advanced non-small cell lung cancer patients treated with chemoradiotherapy
复制标题
预测接受放化疗的局部晚期非小细胞肺癌患者放射性肺炎的功能和生物学指标
DOI：
10.1007/s12094-012-0890-3
复制
发表时间：
2012-12-01
影响因子：
3.4
通讯作者：
Huo, Zongwei
中科院分区：
文献类型：
--
作者：
Wang, Dongqing;Zhu, Jingyu;Huo, Zongwei
研究功能和生物学指标在预测接受放化疗的局部晚期非小细胞肺癌（LANSCLC）患者放射性肺炎（RP）中的预测价值。2006年3月至2010年4月期间，57例LANSCLC患者参与了一项前瞻性研究。单光子发射计算机断层扫描（SPECT）与计算机断层扫描融合提供了灌注加权功能剂量 - 体积直方图（DVH）以及相关的功能剂量学参数。在放疗前以及治疗期间40 Gy/4周时采集血液用于检测血清生物标志物 - 白细胞介素 - 6（IL - 6）、转化生长因子 - β1和超氧化物歧化酶（SOD）。RP的发生率与功能和生物学指标相关。根据受试者工作特征（ROC）曲线下面积（AUC）计算并比较预测因子的可预测性。在以5 Gy为增量给予超过5 - 50 Gy阈值剂量时功能性肺的相对体积以及在给予40 Gy/4周后血清SOD水平升高与RP相关（p < 0.05）。当SOD的截断值为56 U/ml时，观察到其最佳预测效能，敏感度为0.80（95%置信区间0.28 - 0.99），特异度为0.67（95%置信区间0.43 - 0.65）（p = 0.040）。对于基线肺功能较差的患者，功能DVH比标准DVH提供了更好的预测结果（AUC为0.76 - 0.98比0.62 - 0.86）。功能指标被确定为基线肺功能较差患者RP的更好预测因子。SOD似乎是RP的一个潜在预测因子；然而，需要使用更大的样本量进一步验证。
To study the predictive value of functional and biologic metrics for predicting radiation pneumonitis (RP) in locally advanced non-small cell lung cancer (LANSCLC) patients treated with chemoradiotherapy.Between March 2006 and April 2010, 57 LANSCLC patients were enrolled in a prospective study. Fusion of SPECT and computed tomography scans provides perfusion-weighted functional dose-volume histogram (DVH) and associated functional dosimetric parameters. Blood for serum biomarkers-interleukin-6 (IL-6), transforming growth factor-beta1, and superoxide dismutase (SOD)-was drawn pre-RT and then 40 Gy/4 weeks during the treatment. The incidence of RP was related to the functional and biologic metrics. The predictability of predictors was calculated and compared based on the area under receiver-operating characteristic (ROC) curve (AUC).Relative volumes of functional lung receiving more than a threshold dose of 5-50 Gy at increments of 5 Gy and elevated levels of serum SOD after delivery of 40 Gy/4 weeks were associated with RP (p < 0.05). The best predictive efficacy of SOD was observed for a cutoff value of 56 U/ml, with a sensitivity of 0.80 (95 % CI 0.28-0.99) and a specificity of 0.67 (95 % CI 0.43-0.65) (p = 0.040). Functional DVH provided better predictive outcome (AUC 0.76-0.98) than standard DVH (AUC 0.62-0.86) for patients with poor baseline lung function.Functional metrics were identified to be better predictors for RP in patients with poor baseline lung function. SOD seemed to be a potential predictor for RP; however, it will need to be further verified using a larger sample size.