Radiation pneumonitis in patients treated for malignant pulmonary lesions with hypofractionated radiation therapy
Radiation pneumonitis in patients treated for malignant pulmonary lesions with hypofractionated radiation therapy
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DOI：
10.1016/j.radonc.2009.02.003
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发表时间：
2009-06-01
影响因子：
5.7
通讯作者：
Sonke, Jan-Jakob
中科院分区：
文献类型：
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作者：
Borst, Gerben R.;Ishikawa, Masayori;Sonke, Jan-Jakob
目的：我们评估了立体定向体部放射治疗（SBRT）后平均肺剂量（MLD）与放射性肺炎（RP）发生率之间的关系，并将其与常规分割放射治疗（CFRT）进行了比较。材料和方法：对于SBRT（n=128）和CFRT（n=142）患者，RP分级≥ 2。使用最大对数似然分析拟合预测RP概率作为MLD函数的毒性模型。的MLD是NTD（归一化总剂量）校正使用α/β比为3戈伊.Results：SBRT患者进行治疗，6-12戈伊，每部分的中位数MLD为6.4戈伊（范围：1.5-6.5戈伊）。CFRT患者接受2戈伊或2.25戈伊/次治疗，中位MLD为13.2戈伊（范围：3.0-23.0戈伊）。SBRT和CFRT患者RP的粗发生率分别为10.9%和17.6%。SBRT后RP的剂量-反应关系与CFRT的剂量-反应关系无显著差异（p = 0.18）。结论：SBRT后RP的风险与MLD之间存在显著的剂量-反应关系。该关系与CFRT的剂量-反应关系无显著差异，尽管高剂量范围内患者数量少阻碍了统计分析。D 2009由爱思唯尔爱尔兰有限公司出版。放射治疗和肿瘤学91（2009）307-313
Purpose: We evaluated the relationship between the mean lung dose (MLD) and the incidence of radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT), and compared this with conventional fractionated radiation therapy (CFRT).Materials and methods: For both SBRT (n=128) and CFRT (n=142) patients, RP grade >= 2 was scored. Toxicity models predicting the probability of RP as a function of the MLD were fitted Using Maximum log likelihood analysis. The MLD was NTD (Normalized Total Dose) corrected using an alpha/beta ratio of 3 Gy.Results: SBRT patients were treated with 6-12 Gy per fraction with a median MLD of 6.4 Gy (range: 1.5-6.5 Gy). CFRT patients were treated with 2 Gy or 2.25 Gy per fraction, the median MLD was 13.2 Gy (range: 3.0-23.0 Gy). The crude incidence rates of RP were 10.9% and 17.6% for the SBRT and CFRT patients, respectively. A significant close-response relationship for RP was found after SBRT, which was not significantly different from the dose-response relationship for CFRT (p = 0.18).Conclusion: We derived a significant dose-response relationship between the risk of RP and the MLD for SBRT from the clinical data. This relation was not significantly different from the dose-response relation for CFRT, although statistical analysis was hampered by the low number of patients in the high dose range. D 2009 Published by Elsevier Ireland Ltd. Radiotherapy and Oncology 91 (2009) 307-313