Dose-volume parameters predict radiation pneumonitis after surgery with induction concurrent chemoradiotherapy for non-small cell lung cancer

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Abstract

To clarify the relationship between dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) after surgery in cases of non-small cell lung cancer (NSCLC) treated with induction concurrent chemoradiotherapy (CCRT). Patients with NSCLC treated with induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 2.0 Gy fractions once daily for a total of 46 Gy) before surgery were reviewed. We calculated the percentage of lung volume receiving at least 20 Gy (V20) and the mean lung dose (MLD) for the total lung volume and the lung remaining after resection. Factors affecting the incidence of RP at grade 2 or higher (≥G2 RP) were analyzed. Eighteen of 49 patients (37%) experienced ≥G2 RP. The V20 and MLD for the lung remaining after resection (V20r and MLDr) were significant predictors according to the multivariate analysis (p=0.007 and 0.041, respectively). The incidence of ≥G2 RP was 8% in patients with V20r < 10%, and 13% in patients with MLDr < 5.6 Gy, respectively. The optimal approach to reduce the rate of postoperative RP in patients with induction CCRT for NSCLC is to keep the V20r below 10% and/or the MLDr below 5.6 Gy in the radiotherapy planning.

Original languageEnglish
Pages (from-to)507-513
Number of pages7
JournalActa Medica Okayama
Volume72
Issue number5
Publication statusPublished - Jan 1 2018

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Chemoradiotherapy
Radiation Pneumonitis
Non-Small Cell Lung Carcinoma
Surgery
Dosimetry
Cells
Radiation
Lung
Radiotherapy
docetaxel
Chemotherapy
Incidence
Cisplatin
Multivariate Analysis
Planning
Drug Therapy

Keywords

  • Induction chemoradiotherapy
  • Mean lung dose
  • Non-small cell lung cancer
  • Radiation pneumonitis
  • V20

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

@article{97bb0d1109854cfe83dc93a79fb68b31,
title = "Dose-volume parameters predict radiation pneumonitis after surgery with induction concurrent chemoradiotherapy for non-small cell lung cancer",
abstract = "To clarify the relationship between dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) after surgery in cases of non-small cell lung cancer (NSCLC) treated with induction concurrent chemoradiotherapy (CCRT). Patients with NSCLC treated with induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 2.0 Gy fractions once daily for a total of 46 Gy) before surgery were reviewed. We calculated the percentage of lung volume receiving at least 20 Gy (V20) and the mean lung dose (MLD) for the total lung volume and the lung remaining after resection. Factors affecting the incidence of RP at grade 2 or higher (≥G2 RP) were analyzed. Eighteen of 49 patients (37{\%}) experienced ≥G2 RP. The V20 and MLD for the lung remaining after resection (V20r and MLDr) were significant predictors according to the multivariate analysis (p=0.007 and 0.041, respectively). The incidence of ≥G2 RP was 8{\%} in patients with V20r < 10{\%}, and 13{\%} in patients with MLDr < 5.6 Gy, respectively. The optimal approach to reduce the rate of postoperative RP in patients with induction CCRT for NSCLC is to keep the V20r below 10{\%} and/or the MLDr below 5.6 Gy in the radiotherapy planning.",
keywords = "Induction chemoradiotherapy, Mean lung dose, Non-small cell lung cancer, Radiation pneumonitis, V20",
author = "Takeshi Ogata and Kuniaki Katsui and Kotaro Yoshio and Hiroki Ihara and Norihisa Katayama and Junichi Sou and Masahiro Kuroda and Katsuyuki Kiura and Yoshinobu Maeda and Shinichi Toyooka and Susumu Kanazawa",
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language = "English",
volume = "72",
pages = "507--513",
journal = "Acta Medica Okayama",
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T1 - Dose-volume parameters predict radiation pneumonitis after surgery with induction concurrent chemoradiotherapy for non-small cell lung cancer

AU - Ogata, Takeshi

AU - Katsui, Kuniaki

AU - Yoshio, Kotaro

AU - Ihara, Hiroki

AU - Katayama, Norihisa

AU - Sou, Junichi

AU - Kuroda, Masahiro

AU - Kiura, Katsuyuki

AU - Maeda, Yoshinobu

AU - Toyooka, Shinichi

AU - Kanazawa, Susumu

PY - 2018/1/1

Y1 - 2018/1/1

N2 - To clarify the relationship between dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) after surgery in cases of non-small cell lung cancer (NSCLC) treated with induction concurrent chemoradiotherapy (CCRT). Patients with NSCLC treated with induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 2.0 Gy fractions once daily for a total of 46 Gy) before surgery were reviewed. We calculated the percentage of lung volume receiving at least 20 Gy (V20) and the mean lung dose (MLD) for the total lung volume and the lung remaining after resection. Factors affecting the incidence of RP at grade 2 or higher (≥G2 RP) were analyzed. Eighteen of 49 patients (37%) experienced ≥G2 RP. The V20 and MLD for the lung remaining after resection (V20r and MLDr) were significant predictors according to the multivariate analysis (p=0.007 and 0.041, respectively). The incidence of ≥G2 RP was 8% in patients with V20r < 10%, and 13% in patients with MLDr < 5.6 Gy, respectively. The optimal approach to reduce the rate of postoperative RP in patients with induction CCRT for NSCLC is to keep the V20r below 10% and/or the MLDr below 5.6 Gy in the radiotherapy planning.

AB - To clarify the relationship between dose-volume histogram (DVH) parameters and radiation pneumonitis (RP) after surgery in cases of non-small cell lung cancer (NSCLC) treated with induction concurrent chemoradiotherapy (CCRT). Patients with NSCLC treated with induction CCRT (chemotherapy: cisplatin and docetaxel; radiotherapy: 2.0 Gy fractions once daily for a total of 46 Gy) before surgery were reviewed. We calculated the percentage of lung volume receiving at least 20 Gy (V20) and the mean lung dose (MLD) for the total lung volume and the lung remaining after resection. Factors affecting the incidence of RP at grade 2 or higher (≥G2 RP) were analyzed. Eighteen of 49 patients (37%) experienced ≥G2 RP. The V20 and MLD for the lung remaining after resection (V20r and MLDr) were significant predictors according to the multivariate analysis (p=0.007 and 0.041, respectively). The incidence of ≥G2 RP was 8% in patients with V20r < 10%, and 13% in patients with MLDr < 5.6 Gy, respectively. The optimal approach to reduce the rate of postoperative RP in patients with induction CCRT for NSCLC is to keep the V20r below 10% and/or the MLDr below 5.6 Gy in the radiotherapy planning.

KW - Induction chemoradiotherapy

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KW - Radiation pneumonitis

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