scholarly journals Correlation between DVH parameters and lung function changes before and after radiotherapy and the occurrence of radiation-induced lung injury (RILI)

2020 ◽  
Author(s):  
Sha Sha
Keyword(s):  
Radiation Therapy ◽  
Lung Function ◽  
Lung Injury ◽  
Univariate Analysis ◽  
Intensity Modulated Radiation Therapy ◽  
Related Factors ◽  
Logistic Analysis ◽  
Before And After ◽  
Radiation Induced ◽  
Diffusion Function

Abstract Background: The purpose of the study was to explore the correlation between DVH parameters and lung function changes before and after radiotherapy and the occurrence of radiation-induced lung injury (RILI), and to evaluate its value in predicting the risk of RILI.Methods: 120 patients with advanced non-small cell lung cancer who had been diagnosed in Jiaozhou Central Hospital of Qingdao City in the past three years and received chest conformal (intensity modulated) radiation therapy were selected. Before radiotherapy, irradiation of 45-50 Gy, and 1 month after the end of radiotherapy, the patients were tested for lung function, and the ventilation and diffusion function of the patients were tested using the Japanese CHESTAC-8800 lung function tester. The evaluation of radiation lung injury was based on the RTOG acute radiation lung injury classification standard, and the observation end point was ≥2 grade RILI.Results: A total of 34 patients with ≥2 grade RILI among 120 patients in this study, including 23 cases of grade 2 and 11 cases of grade 3, the incidence rate was 28.33%. The difference between FVC, FEV1, FEV1 / FVC, DLCO, V5, V10, V15 before radiotherapy, 45-50 Gy, and 1 month after the end of radiotherapy were statistically significant (P <0.05). Univariate analysis showed that lung function, V5, V10, and V15 before radiotherapy were related factors for RILI (P <0.05). Multivariate logistic analysis showed that the risk of RILI was 1.855 times that of patients with higher FEV1 / FVC before radiation therapy (OR = 1.855, 95% CI = 1.199-1.946, P = 0.037), patients with V10 ≥50% were 3.673 times higher than patients with V10 <50% (OR = 3.673, 95% CI = 1.548-7.582, P = 0.039).Conclusions: V10≥50% and FEV1 / FVC are high-risk factors for RILI before radiotherapy, which has certain value in predicting the risk of RILI.

scholarly journals Radiation Therapy Planning of Thoracic Tumors: A Review of Challenges Associated With Lung Toxicities and Potential Perspectives of Gallium-68 Lung PET/CT Imaging

2021 ◽  
Vol 8 ◽  
Author(s):  
François Lucia ◽  
Martin Rehn ◽  
Frédérique Blanc-Béguin ◽  
Pierre-Yves Le Roux
Keyword(s):  
Radiation Therapy ◽  
Lung Function ◽  
Lung Injury ◽  
Ct Imaging ◽  
Therapy Planning ◽  
Significant Treatment ◽  
Radiation Therapy Planning ◽  
Pet Ct ◽  
Thoracic Radiation ◽  
Radiation Induced

Despite the introduction of new radiotherapy techniques, such as intensity modulated radiation therapy or stereotactic body radiation therapy, radiation induced lung injury remains a significant treatment related adverse event of thoracic radiation therapy. Functional lung avoidance radiation therapy is an emerging concept in the treatment of lung disease to better preserve lung function and to reduce pulmonary toxicity. While conventional ventilation/perfusion (V/Q) lung scintigraphy is limited by a relatively low spatial and temporal resolution, the recent advent of 68Gallium V/Q lung PET/CT imaging offers a potential to increase the accuracy of lung functional mapping and to better tailor lung radiation therapy plans to the individual's lung function. Lung PET/CT imaging may also improve our understanding of radiation induced lung injury compared to the current anatomical based dose–volume constraints. In this review, recent advances in radiation therapy for the management of primary and secondary lung tumors and in V/Q PET/CT imaging for the assessment of functional lung volumes are reviewed. The new opportunities and challenges arising from the integration of V/Q PET/CT imaging in radiation therapy planning are also discussed.

scholarly journals RONC-19. TWO CASES OF RE-IRRADIATION FOR LATE RECURRENT OR RADIATION-INDUCED TUMOR AFTER RADIATION THERAPY FOR PEDIATRIC BRAIN TUMORS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii459-iii459
Author(s):  
Takashi Mori ◽  
Shigeru Yamaguchi ◽  
Rikiya Onimaru ◽  
Takayuki Hashimoto ◽  
Hidefumi Aoyama
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Tumor Resection ◽  
Intensity Modulated Radiation Therapy ◽  
Late Recurrence ◽  
Pediatric Brain Tumors ◽  
Suprasellar Region ◽  
Radiation Induced ◽  
Pediatric Brain

Abstract BACKGROUND As the outcome of pediatric brain tumors improves, late recurrence and radiation-induced tumor cases are more likely to occur, and the number of cases requiring re-irradiation is expected to increase. Here we report two cases performed intracranial re-irradiation after radiotherapy for pediatric brain tumors. CASE 1: 21-year-old male. He was diagnosed with craniopharyngioma at eight years old and underwent a tumor resection. At 10 years old, the local recurrence of suprasellar region was treated with 50.4 Gy/28 fr of stereotactic radiotherapy (SRT). After that, other recurrent lesions appeared in the left cerebellopontine angle, and he received surgery three times. The tumor was gross totally resected and re-irradiation with 40 Gy/20 fr of SRT was performed. We have found no recurrence or late effects during the one year follow-up. CASE 2: 15-year-old female. At three years old, she received 18 Gy/10 fr of craniospinal irradiation and 36 Gy/20 fr of boost to the posterior fossa as postoperative irradiation for anaplastic ependymoma and cured. However, a anaplastic meningioma appeared on the left side of the skull base at the age of 15, and 50 Gy/25 fr of postoperative intensity-modulated radiation therapy was performed. Two years later, another meningioma developed in the right cerebellar tent, and 54 Gy/27 fr of SRT was performed. Thirty-three months after re-irradiation, MRI showed a slight increase of the lesion, but no late toxicities are observed. CONCLUSION The follow-up periods are short, however intracranial re-irradiation after radiotherapy for pediatric brain tumors were feasible and effective.

A review on radiation induced nausea and vomiting: “Current management strategies and prominence of radio sensitizers”

2021 ◽  
pp. 107815522110115
Author(s):  
Meenu Vijayan ◽  
Sherin Joseph ◽  
Emmanuel James ◽  
Debnarayan Dutta
Keyword(s):  
Radiation Therapy ◽  
Cell Damage ◽  
Genetic Material ◽  
High Energy ◽  
Concurrent Chemotherapy ◽  
Nausea And Vomiting ◽  
Dose Fractionation ◽  
Psychological State ◽  
Related Factors ◽  
Radiation Induced

Radiations dissipated are high energy waves used mostly as treatment intervention in controlling the unwanted multiplication of cell. About 60%–65% of cancer treatment requires radiation therapy and 40%–80% of radiation therapy causes RINV which are true troublemakers. Radiation therapy (RT) is targeted therapy mostly used to treat early stages of tumour and prevent their reoccurrence. They mainly destroy the genetic material (DNA) of cancerous cells to avoid their unwanted growth and division. The RINV affects the management and quality of life of patients which further reduces the patient outcome. RINV depends on RT related factors (dose, fractionation, irradiation volume, RT techniques) and patient related factors like (gender, health conditions, age, concurrent chemotherapy, psychological state, and tumour stage). RT is an active area of research and there is only limited progress in tackling the RINV crisis. Advanced technological methods are adopted that led to better understanding of total lethal doses. Radiation therapy also affects the immunity system that leads to radiation induced immune responses and inflammation. Radio sensitizers are used to sensitize the tumour cells to radiations that further prevent the normal cell damage from radiation exposure. There is a need for future studies and researches to re-evaluate the data available from previous trials in RINV to make better effective antiemetic regimen. The article focuses on radiation therapy induced nausea and vomiting along with their mechanism of action and treatment strategies in order to have a remarkable patient care.

scholarly journals Early Clinical Outcomes of Intensity Modulated Radiation Therapy/Intensity Modulated Proton Therapy Combination in Comparison with Intensity Modulated Radiation Therapy Alone in Oropharynx Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1549
Author(s):  
Han Gyul Yoon ◽  
Yong Chan Ahn ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Seung Gyu Park ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Combination Group ◽  
Intensity Modulated Proton Therapy ◽  
Oropharynx Cancer ◽  
Intensity Modulated ◽  
Before And After ◽  
Grade 3 ◽  
Early Clinical Outcomes

Purpose: To report the early clinical outcomes of combining intensity-modulated radiation therapy (IMRT) and intensity-modulated proton therapy (IMPT) in comparison with IMRT alone in treating oropharynx cancer (OPC) patients. Materials and Methods: The medical records of 148 OPC patients who underwent definitive radiotherapy (RT) with concurrent systemic therapy, from January 2016 till December 2019 at Samsung Medical Center, were retrospectively reviewed. During the 5.5 weeks’ RT course, the initial 16 (or 18) fractions were delivered by IMRT in all patients, and the subsequent 12 (or 10) fractions were either by IMRT in 81 patients (IMRT only) or by IMPT in 67 (IMRT/IMPT combination), respectively, based on comparison of adaptive re-plan profiles and availability of equipment. Propensity-score matching (PSM) was done on 76 patients (38 from each group) for comparative analyses. Results: With the median follow-up of 24.7 months, there was no significant difference in overall survival and progression free survival between groups, both before and after PSM. Before PSM, the IMRT/IMPT combination group experienced grade ≥ 3 acute toxicities less frequently: mucositis in 37.0% and 13.4% (p < 0.001); and analgesic quantification algorithm (AQA) in 37.0% and 19.4% (p = 0.019), respectively. The same trends were observed after PSM: mucositis in 39.5% and 15.8% (p = 0.021); and AQA in 47.4% and 21.1% (p = 0.016), respectively. In multivariate logistic regression, grade ≥ 3 mucositis was significantly less frequent in the IMRT/IMPT combination group, both before and after PSM (p = 0.027 and 0.024, respectively). AQA score ≥ 3 was also less frequent in the IMRT/IMPT combination group, both before and after PSM (p = 0.085 and 0.018, respectively). Conclusions: In treating the OPC patients, with comparable early oncologic outcomes, more favorable acute toxicity profiles were achieved following IMRT/IMPT combination than IMRT alone.

Correlation Between Toxicity and Dosimetric Parameters in Patients Treated with Adjuvant Intensity-Modulated Radiation Therapy for Breast Cancer: The Results of a Prospective Study.

2020 ◽  
Author(s):  
David Pasquier ◽  
Benoit Bataille ◽  
Florence Le Tinier ◽  
Raoudha Bennadji ◽  
Hélène Langin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Late Onset ◽  
Univariate Analysis ◽  
Intensity Modulated Radiation Therapy ◽  
Conservative Surgery ◽  
High Dose ◽  
Total Mastectomy ◽  
Intensity Modulated ◽  
A Prospective Study

Abstract Background. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs. Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Methods. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over five weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. Results. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. Most AEs were mild. The most common AEs were skin-related - mainly radiodermatitis (in 266 patients (92.4%)) and hyperpigmentation (in 178 (61.8%)). Smoking (odds ratio) [95%CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs. In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs. In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs. Conclusions. The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters. Trial registration: ClinicalTrials.gov NCT02281149

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