Pulmonary function and quality of life after VMAT-based stereotactic ablative radiotherapy for early stage inoperable NSCLC: a prospective study
| Autor: | Mario Levis, Roberto Torchio, Serena Badellino, Cinzia Ferrero, Luana Focaraccio, Silvia Novello, Francesco Moretto, Andrea Riccardo Filippi, Umberto Ricardi, Matteo Giaj Levra |
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| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty Cancer Research Pulmonary function Lung Neoplasms Pulmonary toxicity Stereotactic body radiotherapy medicine.medical_treatment Kaplan-Meier Estimate SABR volatility model Radiosurgery Pulmonary function testing Risk Factors Diffusing capacity Carcinoma Non-Small-Cell Lung Medicine Humans Lung volumes Prospective Studies Lung cancer Prospective cohort study Aged Neoplasm Staging Aged 80 and over business.industry Early stage respiratory system Middle Aged medicine.disease Radiation pneumonitis Stereotactic ablative radiotherapy Oncology respiratory tract diseases Respiratory Function Tests Radiation therapy Treatment Outcome Physical therapy Quality of Life Female Radiology business |
| Zdroj: | Lung cancer (Amsterdam, Netherlands). 89(3) |
| ISSN: | 1872-8332 |
| Popis: | Objectives To analyze changes in pulmonary function and quality of life (QoL) at different time points after Stereotactic Ablative Radiotherapy (SABR) for early stage inoperable lung cancer, and potential correlations between radiation dose-volume parameters and pulmonary toxicity or changes in pulmonary function tests (PFT) and QoL. Materials and methods From July 2012 to October 2013, 30 patients were enrolled in this prospective observational study. Complete PFT were performed and Lung Cancer Symptoms Scale (LCSS) questionnaire administered prior to SABR; all patients then underwent Computed Tomography (CT) scan and PFT at 45, 135, 225 and 315 days after SABR, together with LCSS questionnaire. Clinical lung toxicity and radiological toxicity (acute and late) were prospectively recorded by using the Radiation Therapy Oncology Group (RTOG) scoring system. Results A decline in Slow Vital Capacity (SVC), Forced Expiratory Volume in 1s (FEV 1 ), Single-breath lung diffusing capacity (D L CO) and blood partial pressure of oxygen (PaO 2 ) was seen at 135 days post-SABR. PaO2 values rescued to normal levels at 315 days. None of the baseline PFT parameters resulted to be associated with the occurrence of pulmonary toxicity or with late radiological changes. Mean V5, V10, and V20 and MLD 2Gy were higher in patients who developed radiation pneumonitis, even if not significantly associated at Cox regression analysis. LCSS QoL showed a significant worsening of the single item fatigue at 135 days after SABR. Conclusions A small (mean 10%) but significant decline in lung volumes and D L CO was recorded after SABR, with clinical impact of such change difficult to estimate in individual patients. Global QoL was not significantly impaired. Dose-volume parameters did not emerge as significantly predictive of any clinical, radiological or functional toxicity. |
| Databáze: | OpenAIRE |
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