Outcome and toxicity of stereotactic body radiotherapy with helical tomotherapy for inoperable lung tumor: analysis of Grade 5 radiation pneumonitis
| Autor: | Takuji Tsubokura, Takuya Nishimura, Kei Yamada, Satoaki Nakamura, Haruumi Okabe, Kana Kobayashi, Naohiro Kodani, Norihiro Aibe, Hideya Yamazaki |
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| Rok vydání: | 2014 |
| Předmět: |
Male
severe radiation pneumonitis medicine.medical_specialty Lung Neoplasms Health Toxicology and Mutagenesis medicine.medical_treatment Comorbidity Radiosurgery Risk Assessment Tomotherapy Pneumonectomy Japan medicine Humans Radiology Nuclear Medicine and imaging Lung cancer Survival rate Aged Aged 80 and over SBRT Radiation Lung business.industry Incidence Incidence (epidemiology) helical tomotherapy Common Terminology Criteria for Adverse Events Middle Aged medicine.disease Combined Modality Therapy Surgery Causality Radiation Pneumonitis Survival Rate lung cancer Treatment Outcome medicine.anatomical_structure Oncology Female Radiotherapy Intensity-Modulated business Nuclear medicine |
| Zdroj: | Journal of Radiation Research |
| ISSN: | 1349-9157 0449-3060 |
| DOI: | 10.1093/jrr/rrt146 |
| Popis: | To analyze outcomes and toxicities of stereotactic body radiotherapy with helical tomotherapy (HT-SBRT) for inoperable lung tumors, the medical records of 30 patients with 31 lung tumors treated with HT-SBRT were reviewed. The 3-year local control, cause-specific survival and overall survival rates (LC, CCS and OS, respectively) were analyzed using the Kaplan–Meier method. Toxicities were graded using Common Terminology Criteria for Adverse Events ver. 4. To investigate the factors associated with Grade 5 radiation pneumonitis (G5 RP), several parameters were analyzed: (i) patient-specific factors (age, gross tumor volume and PTV, and the interstitial pulmonary shadow on pretreatment CT); and (ii) dosimetry-specific factors (conformity index, homogeneity index, mean lung dose, and V5, V10, V15, V20 and V25 of the total lungs). The median duration of observation for all patients was 36.5 months (range, 4–67 months). The 3-year LC, CCS and OS were 82, 84 and 77%, respectively. Regarding Grade 3 or higher toxicities, two patients (6.7%) developed G5 RP. GTV was significantly associated with G5 RP (P = 0.025), and there were non-significant but slight associations with developing G5 RP for V5 (P = 0.067) and PTV (P = 0.096). HT-SBRT led to standard values of LC, CCS and OS, but also caused a markedly higher incidence of G5 RP. It is essential to optimize patient selection so as to avoid severe radiation pneumonitis in HT-SBRT. |
| Databáze: | OpenAIRE |
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