scholarly journals Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer

2011 ◽  
Vol 29 (3) ◽  
pp. 181 ◽  
Author(s):  
Myungsoo Kim ◽  
Jihae Lee ◽  
Boram Ha ◽  
Rena Lee ◽  
Kyung-Ja Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Radiation Pneumonitis ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung

Predicting radiation pneumonitis in locally advanced stage II–III non-small cell lung cancer using machine learning

2019 ◽  
Vol 133 ◽  
pp. 106-112 ◽  
Author(s):  
José Marcio Luna ◽  
Hann-Hsiang Chao ◽  
Eric S. Diffenderfer ◽  
Gilmer Valdes ◽  
Chidambaram Chinniah ◽  
...  
Keyword(s):  
Machine Learning ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Radiation Pneumonitis ◽  
Locally Advanced ◽  
Small Cell ◽  
Stage Ii ◽  
Advanced Stage ◽  
Small Cell Lung

Potential benefits of volumetric modulated arc therapy to reduce the incidence of ≥ grade 2 radiation pneumonitis in radiotherapy for locally advanced non-small cell lung cancer patients

2021 ◽  
Author(s):  
Nobuki Imano ◽  
Tomoki Kimura ◽  
Daisuke Kawahara ◽  
Riku Nishioka ◽  
Wataru Fukumoto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Radiation Pneumonitis ◽  
Locally Advanced ◽  
Volumetric Modulated Arc Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Conformal Radiation Therapy ◽  
Arc Therapy

Abstract Background The use of volumetric modulated arc therapy is gradually widespread for locally advanced non-small cell lung cancer. The purpose of this study was to identify the factors that caused ≥ grade 2 radiation pneumonitis and evaluate the impact of using volumetric modulated arc therapy on the incidence of ≥ grade 2 radiation pneumonitis by comparing three-dimensional conformal radiation therapy. Methods We retrospectively evaluated 124 patients who underwent radical radiotherapy for locally advanced non-small cell lung cancer in our institution between 2008 and 2019. The following variables were analysed to detect the factors that affected ≥ grade 2 radiation pneumonitis; age, sex, the presence of interstitial lung disease, pulmonary emphysema, tumour location, stage, PTV/lung volume, lung V20Gy, total dose, concurrent chemoradiotherapy, adjuvant immune checkpoint inhibitor, radiotherapy method. Radiation pneumonitis was evaluated using the common terminology criteria for adverse events (version 5.0). Results A total of 84 patients underwent three-dimensional conformal radiation therapy (3D-CRT group) and 40 patients underwent volumetric modulated arc therapy (VMAT group). The cumulative incidence of ≥ grade 2 radiation pneumonitis at 12 months was significantly lower in the VMAT group than in the 3D-CRT group (25% vs. 49.1%). The use of volumetric modulated arc therapy was a significant factor for ≥ grade 2 radiation pneumonitis (HR:0.32, 95% CI: 0.15–0.65, P = 0.0017) in addition to lung V20Gy (≥ 24%, HR:5.72 (95% CI: 2.87–11.4), P < 0.0001) and total dose (≥ 70 Gy, HR:2.64 (95% CI: 1.39–5.03), P = 0.0031) even after adjustment by multivariate analysis. Conclusions We identified factors associated with ≥ grade 2 radiation pneumonitis in radiotherapy for patients with locally advanced non-small cell lung cancer. Volumetric modulated arc therapy has potential benefits to reduce the risk of ≥ grade 2 radiation pneumonitis.

Radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent radiotherapy and gemcitabine after induction with gemcitabine and carboplatin

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e18504-e18504
Author(s):  
R. M. Michel ◽  
D. Gallardo-Rincon ◽  
C. Villarreal-Garza ◽  
A. Astorga-Ramos ◽  
J. Zamora ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Radiation Pneumonitis ◽  
Locally Advanced ◽  
Disease Patient ◽  
Small Cell ◽  
Small Cell Lung ◽  
Thoracic Radiation ◽  
Grade 3

e18504 Background: The combination of chemotherapy (CT) and thoracic radiation (RT) is the standard treatment for locally advanced non-small cell lung cancer (NSCLC). The most favorable CT regime, timing of full-dose CT and the best way to combine CT with RT to maximize systemic and radiosensitizing effects remain to be determined. The aim of this study was to assess the efficacy, safety and tolerability of gemcitabine concurrent with RT after induction CT (gemcitabine + carboplatin) in locally advanced NSCLC. Methods: Patients with histologically proven NSCLC IIIA and IIIB received carboplatin (AUC of 2.5) and gemcitabine (800 mg/m2) on day 1 and 8, every 21 days (two cycles), followed by conventional fractioned RT (60Gy) with concomitant weekly gemcitabine 200 mg/m2 and by consolidation CT. Survival was analyzed with Kaplan-Meier. Results: Median follow-up was of 11.9 months, 11 patients (57.9%) had stage IIIB disease. Patient inclusion was discontinued due to high grade 3/4 radiation pneumonitis events (5/19 patients, 26.3%). One treatment-related death from radiation pneumonitis occurred. The most common hematological side effects grade 3/4 were anemia and neutropenia 3/19 (15.8%) each and thrombocytopenia 4/19 (21.1%) during induction CT. Partial response was observed in 11 patients (57.9%) following induction. After concurrent chemo-radiotherapy, overall response was 68.4%. Four patients underwent surgical resection. Median progression-free survival was 12 ± 1 months (95% CI, 9.8 -14.1). Overall survival was of 21 ± 3.5 months (95% CI, 14–27.9). Conclusions: Concurrent RT with gemcitabine after induction CT with gemcitabine and carboplatin showed a high response rate. However, it is associated with excessive pulmonary toxicity. Adjustments in gemcitabine dosage during RT or changes in RT planning could reduce toxicity. No significant financial relationships to disclose.

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