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Predictive factors of symptomatic radiation pneumonitis in primary and metastatic lung tumors treated with stereotactic ablative body radiotherapy

 Kangpyo Kim  ;  Jeongshim Lee  ;  Yeona Cho  ;  Seung Yeun Chung  ;  Jason Joon Bock Lee  ;  Chang Geol Lee  ;  Jaeho Cho 
 RADIATION ONCOLOGY JOURNAL, Vol.35(2) : 163-171, 2017-06 
Journal Title
Issue Date
Lung cancer ; Radiation pneumonitis ; Risk factors ; Stereotactic ablative body radiotherapy
Purpose: Although stereotactic ablative body radiotherapy (SABR) is widely used therapeutic technique, predictive factors of radiation pneumonitis (RP) after SABR remain undefined. We aimed to investigate the predictive factors affecting RP in patients with primary or metastatic lung tumors who received SABR. Materials and methods: From 2012 to 2015, we reviewed 59 patients with 72 primary or metastatic lung tumors treated with SABR, and performed analyses of clinical and dosimetric variables related to symptomatic RP. SABR was delivered as 45-60 Gy in 3-4 fractions, which were over 100 Gy in BED when the α/β value was assumed to be 10. Tumor volume and other various dose volume factors were analyzed using median value as a cutoff value. RP was graded per the Common Terminology Criteria for Adverse Events v4.03. Results: At the median follow-up period of 11 months, symptomatic RP was observed in 13 lesions (12 patients, 18.1%), including grade 2 RP in 11 lesions and grade 3 in 2 lesions. Patients with planning target volume (PTV) of ≤14.35 mL had significantly lower rates of symptomatic RP when compared to others (8.6% vs. 27%; p = 0.048). Rates of symptomatic RP in patients with internal gross tumor volume (iGTV) >4.21 mL were higher than with ≤4.21 mL (29.7% vs. 6.1%; p = 0.017). Conclusions: The incidence of symptomatic RP following treatment with SABR was acceptable with grade 2 RP being observed in most patients. iGTV over 4.21 mL and PTV of over 14.35 mL were significant predictive factors related to symptomatic RP.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kangpyo(김강표)
Lee, Jeong Shim(이정심)
Lee, Jason Joon Bock(이준복)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Chung, Seung Yeun(정승연) ORCID logo https://orcid.org/0000-0002-3877-6950
Cho, Yeona(조연아) ORCID logo https://orcid.org/0000-0002-1202-0880
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
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