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. 2013 Mar 1;85(3):798-804.
doi: 10.1016/j.ijrobp.2012.06.040. Epub 2012 Jul 24.

Poor baseline pulmonary function may not increase the risk of radiation-induced lung toxicity

Jingbo Wang  1 , Jianzhong Cao, Shuanghu Yuan, Wei Ji, Douglas Arenberg, Jianrong Dai, Paul Stanton, Daniel Tatro, Randall K Ten Haken, Luhua Wang, Feng-Ming Spring Kong
Affiliations

Poor baseline pulmonary function may not increase the risk of radiation-induced lung toxicity

Jingbo Wang et al. Int J Radiat Oncol Biol Phys. .

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-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.

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Conflict of interest statement

None of authors have conflict of interest.

Figures

Figure 1
Figure 1
Individual based scatter plot indicates no linear correlation between MLD and FEV1.
Figure 2
Figure 2
The combination of age, FEV1 and MLD displays mild improvement in prediction of SRILT as compared with MLD alone.
See this image and copyright information in PMC

References

    1. Kong FM, Ten Haken RK, Schipper MJ, et al. High-dose radiation improved local tumor control and overall survival in patients with inoperable/unresectable non-small-cell lung cancer: Long-term results of a radiation dose escalation study. Int J Radiat Oncol Biol Phys. 2005;63:324–333. - PubMed
    1. Bradley J, Graham MV, Winter K, et al. Toxicity and outcome results of RTOG 9311: a phase I-II dose-escalation study using three-dimensional conformal radiotherapy in patients with inoperable non-small-cell lung carcinoma. Int J Radiat Oncol Biol Phys. 2005;61:318–328. - PubMed
    1. Rosenzweig KE, Fox JL, Yorke E, et al. Results of a phase I dose-escalation study using three-dimensional conformal radiotherapy in the treatment of inoperable nonsmall cell lung carcinoma. Cancer. 2005;103:2118–2127. - PubMed
    1. Jin HK, Tucker SL, Liu HH, et al. Dose-volume thresholds and smoking status for the risk of treatment-related pneumonitis in inoperable non-small cell lung cancer treated with definitive radiotherapy. Radiother Oncol. 2009;91:427–432. - PMC - PubMed
    1. Zhao L, Wang L, Ji W, et al. Elevation of plasma TGF-beta1 during radiation therapy predicts radiation-induced lung toxicity in patients with non-small-cell lung cancer: a combined analysis from Beijing and Michigan. Int J Radiat Oncol Biol Phys. 2009;74:1385–1390. - PubMed

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