Risk factors for radiation pneumonitis in lung cancer patients with subclinical interstitial lung disease after thoracic radiation therapy

Abstract Background Previous studies have found that patients with subclinical interstitial lung disease (ILD) are highly susceptible to developing radiation pneumonitis (RP) after thoracic radiation therapy. In the present study we aimed to evaluate the incidence of and risk factors for RP after thoracic intensity-modulated radiation therapy in lung cancer patients with subclinical ILD. Methods We retrospectively analyzed data from lung cancer patients with subclinical ILD who were treated with thoracic intensity-modulated radiation therapy with a prescribed dose of ≥ 50 Gy in our institution between January 2016 and December 2017. Results Eighty-seven consecutive lung cancer patients with subclinical ILD were selected for the study. The median follow-up period was 14.0 months. The cumulative incidence of grades ≥ 2 and ≥ 3 RP at one year was 51.0% and 20.9%, respectively. In the multivariate analysis, a mean lung dose ≥ 12 Gy was a significant risk factor for grade ≥ 2 RP (p = 0.049). Chemotherapy with gemcitabine in the past, V5 ≥ 50%, and subclinical ILD involving ≥ 25% of the lung volume were significantly associated with grade ≥ 3 RP (p = 0.046, p = 0.040, and p = 0.024, respectively). Conclusion Mean lung dose is a significant risk factor for grade ≥ 2 RP. Lung cancer patients who have received chemotherapy with gemcitabine in the past, V5 ≥ 50%, and those with subclinical ILD involving ≥ 25% of lung volume have an increased risk of grade ≥ 3 RP in lung cancer patients with subclinical ILD.

Download Full-text

Risk Factors for Radiation Pneumonitis in Lung Cancer Patients with Subclinical Interstitial Lung Disease after Thoracic Radiation Therapy

10.21203/rs.3.rs-216709/v1 ◽

2021 ◽

Author(s):

Fangjuan Li ◽

Hui Liu ◽

Hongyu Wu ◽

Shixiong Liang ◽

Yaping Xu

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Cancer Patients ◽

Radiation Pneumonitis ◽

Significant Risk ◽

Significant Risk Factor ◽

Lung Cancer Patients ◽

The Past ◽

Thoracic Radiation ◽

Grade 3

Abstract Background: Previous studies have found that patients with subclinical interstitial lung disease (ILD) are more susceptible to developing radiation pneumonitis (RP) after thoracic radiation therapy. The present study aimed to evaluate the incidence of and risk factors for RP after thoracic intensity-modulated radiation therapy (IMRT) in lung cancer patients with subclinical ILD.Methods: We retrospectively analyzed lung cancer patients with subclinical ILD who were treated with thoracic IMRT with a prescribed dose of ≥50 Gy in our institutions between January 2016 and December 2017.Results: A total of 87 consecutive lung cancer patients with subclinical ILD were selected for the study. The cumulative incidence of grades ≥2 and ≥3 RP at one year was 51.0% and 20.9%, respectively. In the multivariate analysis, the mean lung dose (MLD) ≥12Gy was a significant risk factor for grade ≥2 RP (p = 0.049). Chemotherapy with gemcitabine in the past，V5≥50%，and subclinical ILD involving ≥25% of lung volume were significantly associated with grade ≥3 RP (p = 0.046, p = 0.040, and p = 0.024, respectively).Conclusion: MLD is a significant risk factor for grade ≥2 RP. Lung cancer patients who have received chemotherapy with gemcitabine in the past, V5, and those with subclinical ILD involving ≥25% of lung volume have an increased risk of grade ≥3 RP in lung cancer patients with subclinical ILD.

Download Full-text

Acute Esophagus Toxicity in Lung Cancer Patients After Intensity Modulated Radiation Therapy and Concurrent Chemotherapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2012.03.027 ◽

2012 ◽

Vol 84 (2) ◽

pp. e223-e228 ◽

Cited By ~ 48

Author(s):

Margriet Kwint ◽

Wilma Uyterlinde ◽

Jasper Nijkamp ◽

Chun Chen ◽

Josien de Bois ◽

...

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Cancer Patients ◽

Intensity Modulated Radiation Therapy ◽

Concurrent Chemotherapy ◽

Lung Cancer Patients ◽

Intensity Modulated

Download Full-text

Incidence of Pneumonitis in Metastatic Lung Cancer Patients Receiving Immune Checkpoint Inhibitors With or Without Thoracic Radiation Therapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.06.348 ◽

2017 ◽

Vol 99 (2) ◽

pp. S150

Author(s):

W. Hwang ◽

A. Niemierko ◽

H. Willers ◽

J. Gainor ◽

F.K. Keane

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Cancer Patients ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Metastatic Lung Cancer ◽

Lung Cancer Patients ◽

Thoracic Radiation ◽

Metastatic Lung

Download Full-text

Hospitalization of hyperglycemic lung cancer patients during treatment

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.9560 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 9560-9560

Author(s):

B. E. Martin ◽

F. Mott ◽

J. Song

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Significant Risk ◽

Serum Glucose ◽

Chemotherapy Cycle ◽

Baseline Serum ◽

Lung Cancer Patients ◽

Treatment Data ◽

Grade 3 ◽

Cancer Experience

9560 Background: Approximately 20 million Americans have type 2 diabetes mellitus. This same group is at significant risk of developing malignancy. Evidence suggest that diabetics with colon and breast cancer experience inferior treatment outcomes. There are few direct comparisons of treatment outcome and/or treatment tolerability in those with and without hyperglycemia. There are no such comparisons in lung cancer patients. We anticipate those with hyperglycemia will tolerate treatment less well than those with euglycemia. With this premise, we assessed hospitalization risk between lung cancer patients with normal or elevated baseline serum glucose (BSG) prior to initial chemotherapy cycle. Methods: After obtaining institutional IRB approval, tumor registry analysis identified 364 consecutive individuals diagnosed with lung cancer between 2005 and 2007 at our institution. One hundred and fifteen were excluded: 71 not treated, 17 duplicate entries, 16 stage 1A lung cancer, 8 missing data, 2 glucose under 60 mg/dl, 1 admitted for chemotherapy. Demographic and cancer specific data were obtained from the registry. Chart review yielded: BSG, date of first chemotherapy cycle, date of hospitalization, neutrophil count at admission, radiation therapy 30 days before/after treatment. Data presented was analyzed using multivariate logistic regression. We utilized WHO strata for fasting whole blood glucose measurements. Those presenting with grade 3 (or greater) neutropenia were excluded. Results: See Table . Conclusions: Lung cancer patients with hyperglycemia are more likely to be hospitalized in the 30 days following their first cycle of cytotoxic chemotherapy. We used the WHO glucose strata to analyze our data. Compared to those with normal BSG, those with BSG between 110 and 126 mg/dl were twice as likely to be hospitalized, and those with BSG over 126 mg/dl had four times the risk. We feel this simple metric will improve clinician's treatment decisions. Prospective analysis of diabetic cancer outcomes is needed. [Table: see text] No significant financial relationships to disclose.

Download Full-text