Dose-volume factors predicting radiation pneumonitis in patients receiving salvage radiotherapy for postlobectomy locoregional recurrent non-small-cell lung cancer

Takashi Uno, Koichi Isobe, Hiroyuki Kawakami, Naoyuki Ueno, Tetsuya Kawata, Seiji Yamamoto, Yasuo Sekine, Akira Iyoda, Toshihiko Iizasa, Takehiko Fujisawa, Naoyuki Shigematsu, Hisao Ito

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background. The correlation between treatment-related factors and lung toxicity has not been sufficiently evaluated in salvage radiotherapy. Methods. Twenty-one patients with recurrent non-small- cell lung cancer (NSCLC) after lobectomy received salvage radiotherapy to a total dose of 46-60 Gy. The effects of radiotherapy parameters on the development of radiation pneumonitis (RP) were examined using dose-volume histograms. Results. Grade 1 RP was observed in 4, grade 2 in 2, and grade 3 in 1 patient. Patients who developed RP had a significantly higher value in V dose (V13, V20) parameters and mean lung dose (MLD) than those who did not develop RP. Concerning G2 or higher RP, 3 patients who developed ≥G2 RP had a significantly higher value in V20, V13, and MLD than the remaining patients with P values of 0.01, 0.015, and 0.016, respectively. The mean V20, V13, and MLD in these 3 patients were 27%, 29.3%, and 14.8 Gy, respectively, whereas the mean V20, V13, and MLD in the remaining 18 patients were 15.8%, 18.3%, and 8.8 Gy, respectively. Three of 6 patients with a V20 ≥20% developed ≥G2 RP whereas this did not occur in the remaining patients (P = 0.015). Similarly, 3 of 6 patients with a V13 ≥23% developed ≥G2 RP whereas this did not occur in the remaining patients (P = 0.015). Conclusions. These data suggest that a somewhat lower V dose value or MLD, as compared with the setting of definitive radiotherapy, could be a surrogate for RP in patients undergoing salvage radiotherapy for recurrent NSCLC.

Original languageEnglish
Pages (from-to)55-59
Number of pages5
JournalInternational Journal of Clinical Oncology
Volume11
Issue number1
DOIs
Publication statusPublished - 2006 Feb 1

Keywords

  • Dose-volume histogram
  • Mean lung dose
  • Non-small-cell lung cancer
  • Radiation pneumonitis
  • Radiotherapy
  • Salvage

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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