Chemoradiotherapy for locally advanced lung cancer patients with interstitial lung abnormalities

Hisao Higo, Toshio Kubo, Satoko Makimoto, Go Makimoto, Hiroki Ihara, Yoshihisa Masaoka, Takashi Ninomiya, Eiki Ichihara, Kadoaki Oohashi, Akiko Sato, Katsuyuki Hotta, Masahiro Tabata, Nagio Takigawa, Yoshinobu Maeda, Katsuyuki Kiura

Research output: Contribution to journalArticle

Abstract

Introduction: Although chemoradiotherapy for locally advanced lung cancer has the potential for cure, treatment is avoided in patients with interstitial lung disease because of the risk for severe radiation pneumonitis. Interstitial lung abnormalities (ILA) can be evaluated using high-resolution computed tomography (HRCT) to assess interstitial changes. In this study, we retrospectively examined the feasibility and efficacy of chemoradiotherapy for locally advanced lung cancer patients with ILA. Methods: Patients who underwent chemoradiotherapy for locally advanced lung cancer at Okayama University Hospital between 2012 and 2015 were reviewed retrospectively. HRCT prior to treatment was evaluated by one pulmonologist and two radiologists using a sequential reading method. Results: Of the 77 patients enrolled in this study, ILA was present in 25 (32.5%) and indeterminate ILA in 24 patients; 28 patients did not have ILA. Desaturation at rest (SpO2 < 95%) and honeycombing on HRCT were not observed in ILA patients. Only one patient with ILA had a low vital capacity (%VC < 80%). Severe radiation pneumonitis (.Grade 2) occurred in 36.0% of the patients with ILA, but it was controllable; Grade 4 or 5 was not observed. Multivariate analysis showed that >25% of the lung volume receiving >20 Gy was risk factors of severe radiation pneumonitis, but ILA was not. The 2-year survival rates of patients with and without ILA were 56.8% and 74.1%, respectively, but the difference was not significant (P = 0.33). Conclusions: Chemoradiotherapy was feasible and effective in some patient population with ILA without desaturation, low VC and honeycombing on HRCT.

Original languageEnglish
Pages (from-to)458-464
Number of pages7
JournalJapanese journal of clinical oncology
Volume49
Issue number5
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Chemoradiotherapy
Lung Neoplasms
Lung
Radiation Pneumonitis
Tomography
Interstitial Lung Diseases
Reading
Survival Rate
Therapeutics

Keywords

  • High-resolution computed tomography
  • Interstitial lung abnormalities
  • Radiation pneumonitis
  • V20

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

@article{5c69b0beb3354c7ba1720c5fae3f2eb9,
title = "Chemoradiotherapy for locally advanced lung cancer patients with interstitial lung abnormalities",
abstract = "Introduction: Although chemoradiotherapy for locally advanced lung cancer has the potential for cure, treatment is avoided in patients with interstitial lung disease because of the risk for severe radiation pneumonitis. Interstitial lung abnormalities (ILA) can be evaluated using high-resolution computed tomography (HRCT) to assess interstitial changes. In this study, we retrospectively examined the feasibility and efficacy of chemoradiotherapy for locally advanced lung cancer patients with ILA. Methods: Patients who underwent chemoradiotherapy for locally advanced lung cancer at Okayama University Hospital between 2012 and 2015 were reviewed retrospectively. HRCT prior to treatment was evaluated by one pulmonologist and two radiologists using a sequential reading method. Results: Of the 77 patients enrolled in this study, ILA was present in 25 (32.5{\%}) and indeterminate ILA in 24 patients; 28 patients did not have ILA. Desaturation at rest (SpO2 < 95{\%}) and honeycombing on HRCT were not observed in ILA patients. Only one patient with ILA had a low vital capacity ({\%}VC < 80{\%}). Severe radiation pneumonitis (.Grade 2) occurred in 36.0{\%} of the patients with ILA, but it was controllable; Grade 4 or 5 was not observed. Multivariate analysis showed that >25{\%} of the lung volume receiving >20 Gy was risk factors of severe radiation pneumonitis, but ILA was not. The 2-year survival rates of patients with and without ILA were 56.8{\%} and 74.1{\%}, respectively, but the difference was not significant (P = 0.33). Conclusions: Chemoradiotherapy was feasible and effective in some patient population with ILA without desaturation, low VC and honeycombing on HRCT.",
keywords = "High-resolution computed tomography, Interstitial lung abnormalities, Radiation pneumonitis, V20",
author = "Hisao Higo and Toshio Kubo and Satoko Makimoto and Go Makimoto and Hiroki Ihara and Yoshihisa Masaoka and Takashi Ninomiya and Eiki Ichihara and Kadoaki Oohashi and Akiko Sato and Katsuyuki Hotta and Masahiro Tabata and Nagio Takigawa and Yoshinobu Maeda and Katsuyuki Kiura",
year = "2019",
month = "1",
day = "1",
doi = "10.1093/jjco/hyz016",
language = "English",
volume = "49",
pages = "458--464",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Chemoradiotherapy for locally advanced lung cancer patients with interstitial lung abnormalities

AU - Higo, Hisao

AU - Kubo, Toshio

AU - Makimoto, Satoko

AU - Makimoto, Go

AU - Ihara, Hiroki

AU - Masaoka, Yoshihisa

AU - Ninomiya, Takashi

AU - Ichihara, Eiki

AU - Oohashi, Kadoaki

AU - Sato, Akiko

AU - Hotta, Katsuyuki

AU - Tabata, Masahiro

AU - Takigawa, Nagio

AU - Maeda, Yoshinobu

AU - Kiura, Katsuyuki

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Although chemoradiotherapy for locally advanced lung cancer has the potential for cure, treatment is avoided in patients with interstitial lung disease because of the risk for severe radiation pneumonitis. Interstitial lung abnormalities (ILA) can be evaluated using high-resolution computed tomography (HRCT) to assess interstitial changes. In this study, we retrospectively examined the feasibility and efficacy of chemoradiotherapy for locally advanced lung cancer patients with ILA. Methods: Patients who underwent chemoradiotherapy for locally advanced lung cancer at Okayama University Hospital between 2012 and 2015 were reviewed retrospectively. HRCT prior to treatment was evaluated by one pulmonologist and two radiologists using a sequential reading method. Results: Of the 77 patients enrolled in this study, ILA was present in 25 (32.5%) and indeterminate ILA in 24 patients; 28 patients did not have ILA. Desaturation at rest (SpO2 < 95%) and honeycombing on HRCT were not observed in ILA patients. Only one patient with ILA had a low vital capacity (%VC < 80%). Severe radiation pneumonitis (.Grade 2) occurred in 36.0% of the patients with ILA, but it was controllable; Grade 4 or 5 was not observed. Multivariate analysis showed that >25% of the lung volume receiving >20 Gy was risk factors of severe radiation pneumonitis, but ILA was not. The 2-year survival rates of patients with and without ILA were 56.8% and 74.1%, respectively, but the difference was not significant (P = 0.33). Conclusions: Chemoradiotherapy was feasible and effective in some patient population with ILA without desaturation, low VC and honeycombing on HRCT.

AB - Introduction: Although chemoradiotherapy for locally advanced lung cancer has the potential for cure, treatment is avoided in patients with interstitial lung disease because of the risk for severe radiation pneumonitis. Interstitial lung abnormalities (ILA) can be evaluated using high-resolution computed tomography (HRCT) to assess interstitial changes. In this study, we retrospectively examined the feasibility and efficacy of chemoradiotherapy for locally advanced lung cancer patients with ILA. Methods: Patients who underwent chemoradiotherapy for locally advanced lung cancer at Okayama University Hospital between 2012 and 2015 were reviewed retrospectively. HRCT prior to treatment was evaluated by one pulmonologist and two radiologists using a sequential reading method. Results: Of the 77 patients enrolled in this study, ILA was present in 25 (32.5%) and indeterminate ILA in 24 patients; 28 patients did not have ILA. Desaturation at rest (SpO2 < 95%) and honeycombing on HRCT were not observed in ILA patients. Only one patient with ILA had a low vital capacity (%VC < 80%). Severe radiation pneumonitis (.Grade 2) occurred in 36.0% of the patients with ILA, but it was controllable; Grade 4 or 5 was not observed. Multivariate analysis showed that >25% of the lung volume receiving >20 Gy was risk factors of severe radiation pneumonitis, but ILA was not. The 2-year survival rates of patients with and without ILA were 56.8% and 74.1%, respectively, but the difference was not significant (P = 0.33). Conclusions: Chemoradiotherapy was feasible and effective in some patient population with ILA without desaturation, low VC and honeycombing on HRCT.

KW - High-resolution computed tomography

KW - Interstitial lung abnormalities

KW - Radiation pneumonitis

KW - V20

UR - http://www.scopus.com/inward/record.url?scp=85067618636&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067618636&partnerID=8YFLogxK

U2 - 10.1093/jjco/hyz016

DO - 10.1093/jjco/hyz016

M3 - Article

C2 - 30793176

AN - SCOPUS:85067618636

VL - 49

SP - 458

EP - 464

JO - Japanese Journal of Clinical Oncology

JF - Japanese Journal of Clinical Oncology

SN - 0368-2811

IS - 5

ER -