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Title: Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity

Abstract

Purpose: Poor pulmonary function (PF) is often considered a contraindication to definitive radiation therapy for lung cancer. This study investigated whether baseline PF was associated with radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) receiving conformal radiation therapy (CRT). Methods and Materials: NSCLC patients treated with CRT and tested for PF at baseline were eligible. Baseline predicted values of forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and diffusion capacity of lung for carbon monoxide (DLCO) were analyzed. Additional factors included age, gender, smoking status, Karnofsky performance status, coexisting chronic obstructive pulmonary disease (COPD), tumor location, histology, concurrent chemotherapy, radiation dose, and mean lung dose (MLD) were evaluated for RILT. The primary endpoint was symptomatic RILT (SRILT), including grade ≥2 radiation pneumonitis and fibrosis. Results: There was a total of 260 patients, and SRILT occurred in 58 (22.3%) of them. Mean FEV1 values for SRILT and non-SRILT patients were 71.7% and 65.9% (P=.077). Under univariate analysis, risk of SRILT increased with MLD (P=.008), the absence of COPD (P=.047), and FEV1 (P=.077). Age (65 split) and MLD were significantly associated with SRILT in multivariate analysis. The addition of FEV1 and age with the MLD-basedmore » model slightly improved the predictability of SRILT (area under curve from 0.63-0.70, P=.088). Conclusions: Poor baseline PF does not increase the risk of SRILT, and combining FEV1, age, and MLD may improve the predictive ability.« less

Authors:
 [1];  [2];  [1];  [2];  [3];  [2]; ; ;  [1];  [2];  [1]
  1. Department of Radiation Oncology, University of Michigan/Ann Arbor Veterans Health System, Ann Arbor, Michigan (United States)
  2. Department of Radiation Oncology, Cancer Hospital, Chinese Academic Medical Sciences and Peking Union Medical College, Beijing (China)
  3. Department of Internal Medicine, University of Michigan/Ann Arbor Veterans Health System, Ann Arbor, Michigan (United States)
Publication Date:
OSTI Identifier:
22224383
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 85; Journal Issue: 3; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARBON MONOXIDE; CHEMOTHERAPY; FIBROSIS; HEALTH HAZARDS; HISTOLOGY; LUNGS; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; PNEUMONITIS; RADIATION DOSES; RADIOTHERAPY; SMOKES; TOXICITY

Citation Formats

Wang, Jingbo, Department of Radiation Oncology, Cancer Hospital, Chinese Academic Medical Sciences and Peking Union Medical College, Beijing, Cao, Jianzhong, Yuan, Shuanghu, Ji, Wei, Arenberg, Douglas, Dai, Jianrong, Stanton, Paul, Tatro, Daniel, Ten Haken, Randall K., Wang, Luhua, and Kong, Feng-Ming. Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2012.06.040.
Wang, Jingbo, Department of Radiation Oncology, Cancer Hospital, Chinese Academic Medical Sciences and Peking Union Medical College, Beijing, Cao, Jianzhong, Yuan, Shuanghu, Ji, Wei, Arenberg, Douglas, Dai, Jianrong, Stanton, Paul, Tatro, Daniel, Ten Haken, Randall K., Wang, Luhua, & Kong, Feng-Ming. Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity. United States. https://doi.org/10.1016/J.IJROBP.2012.06.040
Wang, Jingbo, Department of Radiation Oncology, Cancer Hospital, Chinese Academic Medical Sciences and Peking Union Medical College, Beijing, Cao, Jianzhong, Yuan, Shuanghu, Ji, Wei, Arenberg, Douglas, Dai, Jianrong, Stanton, Paul, Tatro, Daniel, Ten Haken, Randall K., Wang, Luhua, and Kong, Feng-Ming. 2013. "Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity". United States. https://doi.org/10.1016/J.IJROBP.2012.06.040.
@article{osti_22224383,
title = {Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity},
author = {Wang, Jingbo and Department of Radiation Oncology, Cancer Hospital, Chinese Academic Medical Sciences and Peking Union Medical College, Beijing and Cao, Jianzhong and Yuan, Shuanghu and Ji, Wei and Arenberg, Douglas and Dai, Jianrong and Stanton, Paul and Tatro, Daniel and Ten Haken, Randall K. and Wang, Luhua and Kong, Feng-Ming},
abstractNote = {Purpose: Poor pulmonary function (PF) is often considered a contraindication to definitive radiation therapy for lung cancer. This study investigated whether baseline PF was associated with radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) receiving conformal radiation therapy (CRT). Methods and Materials: NSCLC patients treated with CRT and tested for PF at baseline were eligible. Baseline predicted values of forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and diffusion capacity of lung for carbon monoxide (DLCO) were analyzed. Additional factors included age, gender, smoking status, Karnofsky performance status, coexisting chronic obstructive pulmonary disease (COPD), tumor location, histology, concurrent chemotherapy, radiation dose, and mean lung dose (MLD) were evaluated for RILT. The primary endpoint was symptomatic RILT (SRILT), including grade ≥2 radiation pneumonitis and fibrosis. Results: There was a total of 260 patients, and SRILT occurred in 58 (22.3%) of them. Mean FEV1 values for SRILT and non-SRILT patients were 71.7% and 65.9% (P=.077). Under univariate analysis, risk of SRILT increased with MLD (P=.008), the absence of COPD (P=.047), and FEV1 (P=.077). Age (65 split) and MLD were significantly associated with SRILT in multivariate analysis. The addition of FEV1 and age with the MLD-based model slightly improved the predictability of SRILT (area under curve from 0.63-0.70, P=.088). Conclusions: Poor baseline PF does not increase the risk of SRILT, and combining FEV1, age, and MLD may improve the predictive ability.},
doi = {10.1016/J.IJROBP.2012.06.040},
url = {https://www.osti.gov/biblio/22224383}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 85,
place = {United States},
year = {Fri Mar 01 00:00:00 EST 2013},
month = {Fri Mar 01 00:00:00 EST 2013}
}