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Title: The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response

Abstract

Purpose: To assess the impact of induction chemotherapy, and associated tumor shrinkage, on the subsequent radiation-related changes in pulmonary function and tumor response. Methods and Materials: As part of a prospective institutional review board-approved study, 91 evaluable patients treated definitively with thoracic radiation therapy (RT) for unresectable lung cancer were analyzed. The rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without pre-RT chemotherapy. In the patients receiving induction chemotherapy, the rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without a response (modified Response Evaluation Criteria in Solid Tumor criteria) to the pre-RT chemotherapy. Comparisons of the rates of improvements in pulmonary function tests (PFTs) post-RT, dyspnea requiring steroids, and percent declines in PFTs post-RT were compared in patient subgroups using Fisher's exact test, analysis of variance, and linear or logistic regression. Results: The use of pre-RT chemotherapy appears to increase the rate of radiation-induced pneumonitis (p = 0.009-0.07), but has no consistent impact on changes in PFTs. The degree of induction chemotherapy-associated tumor shrinkage is not associated with the rate of subsequent RT-associated pulmonary toxicity. The degree of tumor response to chemotherapy is not related tomore » the degree of tumor response to RT. Conclusions: Additional study is needed to better clarify the impact of chemotherapy on radiation-associated disfunction.« less

Authors:
 [1];  [2];  [1];  [3];  [1];  [4];  [1];  [1];  [1];  [5];  [6];  [7]
  1. Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)
  2. (China)
  3. (Turkey)
  4. Department of Medicine, Duke University Medical Center, Durham, NC (United States)
  5. Department of Pulmonary, Allergy, and Critical Care, Duke University Medical Center, Durham, NC (United States)
  6. Department of Biostatistics, Duke University Medical Center, Durham, NC (United States)
  7. Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States). E-mail: lawrence.marks@duke.edu
Publication Date:
OSTI Identifier:
20951578
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.11.003; PII: S0360-3016(06)03370-0; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; LUNGS; PATIENTS; PNEUMONITIS; RADIOTHERAPY; REVIEWS; SHRINKAGE; STEROIDS; TOXICITY

Citation Formats

Mao Jingfang, Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai, Kocak, Zafer, Department of Radiation Oncology, Trakya University Hospital, Edirne, Zhou Sumin, Garst, Jennifer, Evans, Elizabeth S., Zhang Junan, Larrier, Nicole A., Hollis, Donna R., Folz, Rodney J., and Marks, Lawrence B.. The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response. United States: N. p., 2007. Web.
Mao Jingfang, Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai, Kocak, Zafer, Department of Radiation Oncology, Trakya University Hospital, Edirne, Zhou Sumin, Garst, Jennifer, Evans, Elizabeth S., Zhang Junan, Larrier, Nicole A., Hollis, Donna R., Folz, Rodney J., & Marks, Lawrence B.. The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response. United States.
Mao Jingfang, Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai, Kocak, Zafer, Department of Radiation Oncology, Trakya University Hospital, Edirne, Zhou Sumin, Garst, Jennifer, Evans, Elizabeth S., Zhang Junan, Larrier, Nicole A., Hollis, Donna R., Folz, Rodney J., and Marks, Lawrence B.. Sun . "The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response". United States. doi:.
@article{osti_20951578,
title = {The Impact of Induction Chemotherapy and the Associated Tumor Response on Subsequent Radiation-Related Changes in Lung Function and Tumor Response},
author = {Mao Jingfang and Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai and Kocak, Zafer and Department of Radiation Oncology, Trakya University Hospital, Edirne and Zhou Sumin and Garst, Jennifer and Evans, Elizabeth S. and Zhang Junan and Larrier, Nicole A. and Hollis, Donna R. and Folz, Rodney J. and Marks, Lawrence B.},
abstractNote = {Purpose: To assess the impact of induction chemotherapy, and associated tumor shrinkage, on the subsequent radiation-related changes in pulmonary function and tumor response. Methods and Materials: As part of a prospective institutional review board-approved study, 91 evaluable patients treated definitively with thoracic radiation therapy (RT) for unresectable lung cancer were analyzed. The rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without pre-RT chemotherapy. In the patients receiving induction chemotherapy, the rates of RT-associated pulmonary toxicity and tumor response were compared in the patients with and without a response (modified Response Evaluation Criteria in Solid Tumor criteria) to the pre-RT chemotherapy. Comparisons of the rates of improvements in pulmonary function tests (PFTs) post-RT, dyspnea requiring steroids, and percent declines in PFTs post-RT were compared in patient subgroups using Fisher's exact test, analysis of variance, and linear or logistic regression. Results: The use of pre-RT chemotherapy appears to increase the rate of radiation-induced pneumonitis (p = 0.009-0.07), but has no consistent impact on changes in PFTs. The degree of induction chemotherapy-associated tumor shrinkage is not associated with the rate of subsequent RT-associated pulmonary toxicity. The degree of tumor response to chemotherapy is not related to the degree of tumor response to RT. Conclusions: Additional study is needed to better clarify the impact of chemotherapy on radiation-associated disfunction.},
doi = {},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 67,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2007},
month = {Sun Apr 01 00:00:00 EDT 2007}
}