Dose–Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer
Purpose To identify dose–volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in f...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2012-07, Vol.83 (4), p.e545-e549 |
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| creator | Matsuo, Yukinori, M.D., Ph.D Shibuya, Keiko, M.D., Ph.D Nakamura, Mitsuhiro, Ph.D Narabayashi, Masaru, M.D Sakanaka, Katsuyuki, M.D Ueki, Nami, M.D Miyagi, Ken, M.D Norihisa, Yoshiki, M.D Mizowaki, Takashi, M.D., Ph.D Nagata, Yasushi, M.D., Ph.D Hiraoka, Masahiro, M.D., Ph.D |
| description | Purpose To identify dose–volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose–volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose–volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 |
| doi_str_mv | 10.1016/j.ijrobp.2012.01.018 |
| format | Article |
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Methods and Materials This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose–volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose–volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder ( p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV ≥37.7 ml and V25 <4.2%; and patients with PTV ≥37.7 ml and V25 ≥4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively ( p = 0.013). Conclusions Lung V25 and PTV volume were significant factors associated with RP after SBRT.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2012.01.018</identifier><identifier>PMID: 22436782</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Dose–volume analysis ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; LUNGS ; Male ; METRICS ; Middle Aged ; NEOPLASMS ; PATIENTS ; PNEUMONITIS ; RADIATION DOSES ; Radiation pneumonitis ; Radiation Pneumonitis - etiology ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiosurgery - adverse effects ; Radiosurgery - methods ; RADIOTHERAPY ; Radiotherapy Dosage ; Stereotactic body radiation therapy ; Tumor Burden</subject><ispartof>International journal of radiation oncology, biology, physics, 2012-07, Vol.83 (4), p.e545-e549</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c601t-d3f6edfac25d4f9691caa62be19dbe6b938d8eed20729dadbfae9510e62dc1b73</citedby><cites>FETCH-LOGICAL-c601t-d3f6edfac25d4f9691caa62be19dbe6b938d8eed20729dadbfae9510e62dc1b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301612000612$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22436782$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22058978$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Matsuo, Yukinori, M.D., Ph.D</creatorcontrib><creatorcontrib>Shibuya, Keiko, M.D., Ph.D</creatorcontrib><creatorcontrib>Nakamura, Mitsuhiro, Ph.D</creatorcontrib><creatorcontrib>Narabayashi, Masaru, M.D</creatorcontrib><creatorcontrib>Sakanaka, Katsuyuki, M.D</creatorcontrib><creatorcontrib>Ueki, Nami, M.D</creatorcontrib><creatorcontrib>Miyagi, Ken, M.D</creatorcontrib><creatorcontrib>Norihisa, Yoshiki, M.D</creatorcontrib><creatorcontrib>Mizowaki, Takashi, M.D., Ph.D</creatorcontrib><creatorcontrib>Nagata, Yasushi, M.D., Ph.D</creatorcontrib><creatorcontrib>Hiraoka, Masahiro, M.D., Ph.D</creatorcontrib><title>Dose–Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To identify dose–volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose–volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose–volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder ( p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV ≥37.7 ml and V25 <4.2%; and patients with PTV ≥37.7 ml and V25 ≥4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively ( p = 0.013). Conclusions Lung V25 and PTV volume were significant factors associated with RP after SBRT.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Dose–volume analysis</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>LUNGS</subject><subject>Male</subject><subject>METRICS</subject><subject>Middle Aged</subject><subject>NEOPLASMS</subject><subject>PATIENTS</subject><subject>PNEUMONITIS</subject><subject>RADIATION DOSES</subject><subject>Radiation pneumonitis</subject><subject>Radiation Pneumonitis - etiology</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiosurgery - adverse effects</subject><subject>Radiosurgery - methods</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Stereotactic body radiation therapy</subject><subject>Tumor Burden</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks-KFDEQxoMo7uzqG4gEvHjpMUlPpzsXYXd0VRhR3PXPLaSTaidtdzImaWFuvoNv6JOYplcRL0JRIfCr-or6CqEHlKwpofxJv7Z98O1hzQhla0JzNLfQija1KMqq-nQbrUjJSVFm-ASdxtgTQiitN3fRCWObktcNW6HpmY_w8_uPD36YRsCvIQWrIz6P0WurEhj80aY9fqdM_lnv8FsH0-idTTZTXYKAr3ICn5ROVuMLb45_0dd7COpwxJ0PeDe5z3irnIZwD93p1BDh_s17ht5fPr_evix2b1682p7vCs0JTYUpOw6mU5pVZtMJLqhWirMWqDAt8FaUjWkADCM1E0aZtlMgKkqAM6NpW5dn6NHS18dkZdQ2gd5r7xzoJBkjVSPqJlOPF-oQ_NcJYpKjjRqGQTnwU5SUMEoZF4xldLOgOvgYA3TyEOyowjFDcrZF9nKxRc62SEJzzAoPbxSmdgTzp-i3Dxl4ugCQt_HNQpiHhbwqY8M8q_H2fwr_NtCDdVar4QscIfZ-Ci5vWlIZc428mk9jvgzK8lXkXP4CkeG37A</recordid><startdate>20120715</startdate><enddate>20120715</enddate><creator>Matsuo, Yukinori, M.D., Ph.D</creator><creator>Shibuya, Keiko, M.D., Ph.D</creator><creator>Nakamura, Mitsuhiro, Ph.D</creator><creator>Narabayashi, Masaru, M.D</creator><creator>Sakanaka, Katsuyuki, M.D</creator><creator>Ueki, Nami, M.D</creator><creator>Miyagi, Ken, M.D</creator><creator>Norihisa, Yoshiki, M.D</creator><creator>Mizowaki, Takashi, M.D., Ph.D</creator><creator>Nagata, Yasushi, M.D., Ph.D</creator><creator>Hiraoka, Masahiro, M.D., Ph.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20120715</creationdate><title>Dose–Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer</title><author>Matsuo, Yukinori, M.D., Ph.D ; Shibuya, Keiko, M.D., Ph.D ; Nakamura, Mitsuhiro, Ph.D ; Narabayashi, Masaru, M.D ; Sakanaka, Katsuyuki, M.D ; Ueki, Nami, M.D ; Miyagi, Ken, M.D ; Norihisa, Yoshiki, M.D ; Mizowaki, Takashi, M.D., Ph.D ; Nagata, Yasushi, M.D., Ph.D ; Hiraoka, Masahiro, M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c601t-d3f6edfac25d4f9691caa62be19dbe6b938d8eed20729dadbfae9510e62dc1b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Dose–volume analysis</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>LUNGS</topic><topic>Male</topic><topic>METRICS</topic><topic>Middle Aged</topic><topic>NEOPLASMS</topic><topic>PATIENTS</topic><topic>PNEUMONITIS</topic><topic>RADIATION DOSES</topic><topic>Radiation pneumonitis</topic><topic>Radiation Pneumonitis - etiology</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiosurgery - adverse effects</topic><topic>Radiosurgery - methods</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Stereotactic body radiation therapy</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matsuo, Yukinori, M.D., Ph.D</creatorcontrib><creatorcontrib>Shibuya, Keiko, M.D., Ph.D</creatorcontrib><creatorcontrib>Nakamura, Mitsuhiro, Ph.D</creatorcontrib><creatorcontrib>Narabayashi, Masaru, M.D</creatorcontrib><creatorcontrib>Sakanaka, Katsuyuki, M.D</creatorcontrib><creatorcontrib>Ueki, Nami, M.D</creatorcontrib><creatorcontrib>Miyagi, Ken, M.D</creatorcontrib><creatorcontrib>Norihisa, Yoshiki, M.D</creatorcontrib><creatorcontrib>Mizowaki, Takashi, M.D., Ph.D</creatorcontrib><creatorcontrib>Nagata, Yasushi, M.D., Ph.D</creatorcontrib><creatorcontrib>Hiraoka, Masahiro, M.D., Ph.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsuo, Yukinori, M.D., Ph.D</au><au>Shibuya, Keiko, M.D., Ph.D</au><au>Nakamura, Mitsuhiro, Ph.D</au><au>Narabayashi, Masaru, M.D</au><au>Sakanaka, Katsuyuki, M.D</au><au>Ueki, Nami, M.D</au><au>Miyagi, Ken, M.D</au><au>Norihisa, Yoshiki, M.D</au><au>Mizowaki, Takashi, M.D., Ph.D</au><au>Nagata, Yasushi, M.D., Ph.D</au><au>Hiraoka, Masahiro, M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dose–Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2012-07-15</date><risdate>2012</risdate><volume>83</volume><issue>4</issue><spage>e545</spage><epage>e549</epage><pages>e545-e549</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To identify dose–volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose–volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose–volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder ( p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV ≥37.7 ml and V25 <4.2%; and patients with PTV ≥37.7 ml and V25 ≥4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively ( p = 0.013). Conclusions Lung V25 and PTV volume were significant factors associated with RP after SBRT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22436782</pmid><doi>10.1016/j.ijrobp.2012.01.018</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Dose–volume analysis Female Hematology, Oncology and Palliative Medicine Humans Lung Neoplasms - pathology Lung Neoplasms - surgery LUNGS Male METRICS Middle Aged NEOPLASMS PATIENTS PNEUMONITIS RADIATION DOSES Radiation pneumonitis Radiation Pneumonitis - etiology Radiology RADIOLOGY AND NUCLEAR MEDICINE Radiosurgery - adverse effects Radiosurgery - methods RADIOTHERAPY Radiotherapy Dosage Stereotactic body radiation therapy Tumor Burden |
| title | Dose–Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer |
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