Influence Factors for Radiation Pneumonitis in Stage Ⅲ Non-small Cell Lung Cancer Patients Treated with Three-dimensional Conformal Radiotherapy

WANG Yuxiang; TIAN Dandan; QIU Rong; TIAN Xiuming; WANG Lili

doi:10.3971/j.issn.1000-8578.2014.12.012

Cancer Research on Prevention and Treatment > 2014 > 41(12): 1307-1312. > DOI: 10.3971/j.issn.1000-8578.2014.12.012

WANG Yuxiang, TIAN Dandan, QIU Rong, TIAN Xiuming, WANG Lili. Influence Factors for Radiation Pneumonitis in Stage Ⅲ Non-small Cell Lung Cancer Patients Treated with Three-dimensional Conformal Radiotherapy[J]. Cancer Research on Prevention and Treatment, 2014, 41(12): 1307-1312. DOI: 10.3971/j.issn.1000-8578.2014.12.012

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Influence Factors for Radiation Pneumonitis in Stage Ⅲ Non-small Cell Lung Cancer Patients Treated with Three-dimensional Conformal Radiotherapy

Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China( *:Present: Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province,Cangzhou 061001, China)

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Received Date: November 12, 2013
Revised Date: June 30, 2014

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Objective To retrospectively analyze physical parameters and clinical factors for radiation pneumonitis(RP) in stage Ⅲ non-small cell lung cancer(NSCLC) patients treated with three-dimensional conformal radiotherapy(3D-CRT). Methods From January 2001 to December 2008, 203 NSCLC patients were treated with radical 3D-CRT, 163 males and 40 females; Median ages was 63-year-old(30~83); 21 patients were suffered from chronic obstructive pulmonary disease(COPD) medical history; 79 cases were in ⅢA stage and 124 cases were in ⅢB stage; 70 cases were treated with single radiotherapy and 133 cases with chemoradiotherapy, and median equivalent dose was 6 200 cGy (5 000-7 800 cGy). RP was evaluated with RTOG standard, and physical parameters of DVH was used to estimated RP grade≥2 and RP grade≥ 3. SPSS 13.0 software was used for statistic analysis. Results After 3DCRT, the rates of RP grade≥2 and grade≥3 were 32%(65/203) and 20.7%(42/203). Spearman correlation and single factor Logistic analysis showed that the mean lung dose, V5-V40 of total lung, COPD history, fractional radiation style, radiotherapy dose, GTV and GTV/volume of total lung were correlated with RP grade≥2 and grade≥3 (P<0.05); Logistic multivariate analysis revealed that V25 was the independent risk factor for RP grade ≥2 and grade ≥3. The optimal cutoff value for lung V25 was 29% in the receiver-operating characteristic (ROC) curve. COPD was the independent risk factor for RP grade ≥2. Conclusion DVH parameters were associated with the occurrence of RP. V25 might be the most effectively independent risk factor for RP grade≥2 and grade ≥3. COPD was the independent risk factor for RP grade≥2 in patients with non-small cell lung cancer.
- Ⅲ non-small cell lung cancer,
- Three-dimensional conformal radiotherapy(3D-CRT),
- Radiation pneumonitis(RP)

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Influence Factors for Radiation Pneumonitis in Stage Ⅲ Non-small Cell Lung Cancer Patients Treated with Three-dimensional Conformal Radiotherapy

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