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. 2025 May 17;16(1):793.
doi: 10.1007/s12672-025-02569-1.

Segmental bronchi radiation dose affected the progression of radiation pneumonitis in lung cancer patients

Gai Liang #  1 , RuiJie Chang #  2 , Qu Zhang  1 , Yan Luo  1 , Yi Peng  3 , Bo Luo  4
Affiliations

Segmental bronchi radiation dose affected the progression of radiation pneumonitis in lung cancer patients

Gai Liang et al. Discov Oncol. .

Abstract

Objective: To evaluate the association between the segmental bronchi radiation dose and radiation pneumonitis (RP) in patients with lung cancer who underwent radiotherapy.

Methods: A total of 135 patients with lung cancer who were treated with radiation therapy between December 2014 and December 2015 were enrolled in the study. RP was defined and graded according to the criteria of the Radiation Therapy Oncology Group. The radiation dose to the segmental bronchi, along with clinical, and other dosimetric factors were recorded. Logistic regression analysis was used to evaluate the association between the related factors and RP.

Results: Among the 135 enrolled patients, 24 (17.8%) developed grade 3 radiation pneumonitis or higher. Study found that RP was associated with the following factors: patient age, complications with chronic obstructive pulmonary disease, concurrent chemotherapy, percentage of lung volume receiving more than 30 Gy (V30), whole lung volume, and the segmental bronchi maximum and mean dose. Logistic regression analysis showed that the maximum dose of the segmental bronchi, whole lung volume, and V30 were independent risk factors for RP. According to the receiver operating characteristic curve, the maximum dose constraint of the segmental bronchi during radiotherapy is estimated at 23.85 Gy.

Conclusion: The segmental bronchi radiation dose should be considered as a normal tissue constraint, in addition to whole lung volume and V30 in radiotherapy for patients with lung cancer to decrease the incidence of RP.

Keywords: Lung cancer; Radiation; Radiation pneumonitis; Risk factor; Segmental bronchi.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The research was ethically approved by the Ethics Committee of the Hubei Cancer Hospital. Prior to participation, all participants were duly informed of their rights and responsibilities and provided explicit written consent. The study was conducted in agreement with the guidelines governing research involving human participants, as outlined by the Ethics Committee of the Hubei Cancer Hospital. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The contouring of the segmental bronchi in the treatment planning system with the different anatomical levels. The green outline indicates the segmental bronchi. The red outline indicates the gross tumor volume
Fig. 2
Fig. 2
Optimum cutoff value of the segmental bronchi maximum dose (23.85 Gy) by calculating area under the receiver operating characteristic (ROC) curve to prevent radiation pneumonitis
See this image and copyright information in PMC

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