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Heart irradiation as a risk factor for radiation pneumonitis

Abstract

Purpose. To investigate the potential role of incidental heart irradiation on the risk of radiation pneumonitis (RP) for patients receiving definitive radiation therapy for non-small-cell lung cancer (NSCLC). Material and methods. Two hundred and nine patient datasets were available for this study. Heart and lung dose-volume parameters were extracted for modeling, based on Monte Carlo-based heterogeneity corrected dose distributions. Clinical variables tested included age, gender, chemotherapy, pre-treatment weight-loss, performance status, and smoking history. The risk of RP was modeled using logistic regression. Results. The most significant univariate variables were heart related, such as heart heart V65 (percent volume receiving at least 65 Gy) (Spearman Rs = 0.245, p < 0.001). The best-performing logistic regression model included heart D10 (minimum dose to the hottest 10% of the heart), lung D35, and maximum lung dose (Spearman Rs 0.268, p < 0.0001). When classified by predicted risk, the RP incidence ratio between the most and least risky 1/3 of treatments was 4.8. The improvement in risk modeling using lung and heart variables was better than using lung variables alone. Conclusions. These results suggest a previously unsuspected role of heart irradiation in many cases of RP
Publication Date:
Jan 15, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Acta Oncologica (Stockholm) (online); Journal Volume: 50; Journal Issue: 1; Other Information: 10.3109/0284186X.2010.521192
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; NEOPLASMS; PNEUMONITIS; HEART; RADIATION HAZARDS; LUNGS; SIDE EFFECTS
OSTI ID:
1004328
Country of Origin:
Sweden
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1651-226X; TRN: SE1108024
Availability:
Available from DOI: http://dx.doi.org/10.3109/0284186X.2010.521192
Submitting Site:
SWDN
Size:
page(s) 51-60
Announcement Date:
Feb 07, 2011

Citation Formats

Huang, Ellen X, El Naqa, Issam, Deasy, Joseph O, Bradley, Jeffrey D. (Dept. of Radiation Oncology, Mallinckrodt Inst. of Radiology, Washington Univ. School of Medicine, St. Louis, Missouri (United States)), e-mail: jdeasy@radonc.wustl.edu, Hope, Andrew J, Lindsay, Patricia E, and Trovo, Marco. Heart irradiation as a risk factor for radiation pneumonitis. Sweden: N. p., 2011. Web. doi:10.3109/0284186X.2010.521192.
Huang, Ellen X, El Naqa, Issam, Deasy, Joseph O, Bradley, Jeffrey D. (Dept. of Radiation Oncology, Mallinckrodt Inst. of Radiology, Washington Univ. School of Medicine, St. Louis, Missouri (United States)), e-mail: jdeasy@radonc.wustl.edu, Hope, Andrew J, Lindsay, Patricia E, &amp; Trovo, Marco. Heart irradiation as a risk factor for radiation pneumonitis. Sweden. https://doi.org/10.3109/0284186X.2010.521192
Huang, Ellen X, El Naqa, Issam, Deasy, Joseph O, Bradley, Jeffrey D. (Dept. of Radiation Oncology, Mallinckrodt Inst. of Radiology, Washington Univ. School of Medicine, St. Louis, Missouri (United States)), e-mail: jdeasy@radonc.wustl.edu, Hope, Andrew J, Lindsay, Patricia E, and Trovo, Marco. 2011. "Heart irradiation as a risk factor for radiation pneumonitis." Sweden. https://doi.org/10.3109/0284186X.2010.521192.
@misc{etde_1004328,
title = {Heart irradiation as a risk factor for radiation pneumonitis}
author = {Huang, Ellen X, El Naqa, Issam, Deasy, Joseph O, Bradley, Jeffrey D. (Dept. of Radiation Oncology, Mallinckrodt Inst. of Radiology, Washington Univ. School of Medicine, St. Louis, Missouri (United States)), e-mail: jdeasy@radonc.wustl.edu, Hope, Andrew J, Lindsay, Patricia E, and Trovo, Marco}
abstractNote = {Purpose. To investigate the potential role of incidental heart irradiation on the risk of radiation pneumonitis (RP) for patients receiving definitive radiation therapy for non-small-cell lung cancer (NSCLC). Material and methods. Two hundred and nine patient datasets were available for this study. Heart and lung dose-volume parameters were extracted for modeling, based on Monte Carlo-based heterogeneity corrected dose distributions. Clinical variables tested included age, gender, chemotherapy, pre-treatment weight-loss, performance status, and smoking history. The risk of RP was modeled using logistic regression. Results. The most significant univariate variables were heart related, such as heart heart V65 (percent volume receiving at least 65 Gy) (Spearman Rs = 0.245, p < 0.001). The best-performing logistic regression model included heart D10 (minimum dose to the hottest 10% of the heart), lung D35, and maximum lung dose (Spearman Rs 0.268, p < 0.0001). When classified by predicted risk, the RP incidence ratio between the most and least risky 1/3 of treatments was 4.8. The improvement in risk modeling using lung and heart variables was better than using lung variables alone. Conclusions. These results suggest a previously unsuspected role of heart irradiation in many cases of RP}
doi = {10.3109/0284186X.2010.521192}
journal = []
issue = {1}
volume = {50}
place = {Sweden}
year = {2011}
month = {Jan}
}