Heart irradiation as a risk factor for radiation pneumonitis.
Heart irradiation as a risk factor for radiation pneumonitis.
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DOI：
10.3109/0284186x.2010.521192
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发表时间：
2011-01
期刊：
影响因子：
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通讯作者：
Bradley JD
中科院分区：
文献类型：
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作者：
Huang EX;Hope AJ;Lindsay PE;Trovo M;El Naqa I;Deasy JO;Bradley JD
研究心脏偶然照射对接受确定性放射治疗的非小细胞肺癌（NSCLC）患者发生放射性肺炎（RP）风险的潜在作用。本研究有209个患者数据集可用。根据基于蒙特卡罗的异质性校正剂量分布，提取心脏和肺剂量体积参数进行建模。测试的临床变量包括年龄、性别、化疗、治疗前体重减轻、体能状态和吸烟史。RP的风险使用逻辑回归建模。最显著的单变量变量与心脏相关，如心脏V65（接受至少65戈伊照射的体积百分比）（斯皮尔曼Rs = 0.245，p < 0.001）。最佳逻辑回归模型包括心脏D10（心脏最热10%的最小剂量）、肺D35和最大肺剂量（斯皮尔曼Rs = 0.268，p < 0.0001）。当按预测风险分类时，风险最大和风险最小的1/3治疗之间的RP发生率比为4.8。使用肺和心脏变量的风险建模的改善优于单独使用肺变量。这些结果表明，在许多RP病例中，心脏照射具有先前未被怀疑的作用。
To investigate the potential role of incidental heart irradiation on the risk of radiation pneumonitis (RP) for patients receiving definitive radiation therapy for non-small-cell lung cancer (NSCLC). Two hundred and nine patient datasets were available for this study. Heart and lung dose-volume parameters were extracted for modeling, based on Monte Carlo-based heterogeneity corrected dose distributions. Clinical variables tested included age, gender, chemotherapy, pre-treatment weight-loss, performance status, and smoking history. The risk of RP was modeled using logistic regression. The most significant univariate variables were heart related, such as heart heart V65 (percent volume receiving at least 65 Gy) (Spearman Rs = 0.245, p < 0.001). The best-performing logistic regression model included heart D10 (minimum dose to the hottest 10% of the heart), lung D35, and maximum lung dose (Spearman Rs = 0.268, p < 0.0001). When classified by predicted risk, the RP incidence ratio between the most and least risky 1/3 of treatments was 4.8. The improvement in risk modeling using lung and heart variables was better than using lung variables alone. These results suggest a previously unsuspected role of heart irradiation in many cases of RP.