Stereotactic Body Radiation Therapy for Patients with Pulmonary Interstitial Change: High Incidence of Fatal Radiation Pneumonitis in a Retrospective Multi-Institutional Study

Cancers

Yukinori Matsuo¹  Kenji Takayama¹  Tomoki Kimura²  Tuyoshi Takanaka³  Hiromichi Ishiyama⁴  Naoya Murakami⁵  Yasuo Matsumoto⁶  Yuji Seo⁷  Kensei Nakata⁸  Haruo Matsushita⁹  Keiji Nihei^1,10  Takuma Nomiya^1,11  Masahiko Aoki^1,12  Akifumi Miyakawa^1,13  Hiroshi Onishi^1,14  Masayuki Araya^1,14  Takafumi Komiyama^1,14  Ryo Saito^1,14  Kan Marino^1,14  Kengo Kuriyama^1,14  Licht Tominaga^1,14  Shinichi Aoki^1,14  Yoshiyasu Maehata^1,14  Hideomi Yamashita^1,15  Takashi Uno^1,16  Yoshiyuki Shioyama^1,17  Atsuya Takeda^1,18 

[1] Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 6068507, Japan;Department of Radiation Oncology, Hiroshima University Hospital, 1-2-3, Kasumi Minami-ku, Hiroshima 7348551, Japan;Department of Radiation Oncology, Kanazawa University, 13-1 Takaramachi, Kanazawa 9208641, Japan;Department of Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520375, Japan;Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 1040045, Japan;Department of Radiation Oncology, Niigata Cancer Center Hospital, 2-15-3 Kawagishi, Chuo-ku, Niigata 9518566, Japan;Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamada-oka, Suita, Osaka 5650871, Japan;Department of Radiation Oncology, Sapporo Medical University, 16-291 Minami-1jyo-nishi, Chuo-ku, Sapporo-shi, Hokkaido 0608543, Japan;Department of Radiation Oncology, School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan;Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 1138677, Japan;Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata-shi, Yamagata 9909585, Japan;Department of Radiology and Radiation Oncology, Hirosaki University School of Medicine, 5 Zaifu-cho Hirosaki city, Aomori 0368562, Japan;Department of Radiology, School of Medicine, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 4678601, Japan;Department of Radiology, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 4093898, Japan;Department of Radiology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan;Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 2608670, Japan;Ion Beam Therapy Center, SAGA-HIMAT Foundation, 3049 Harukoga-machi, Tosu-shi, Saga 8410071, Japan;Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 2470056, Japan;

关键词: stereotactic body radiation therapy;    lung cancer;    pulmonary interstitial change;    radiation pneumonitis;   

DOI  :  10.3390/cancers10080257

来源: DOAJ

【 摘 要 】

Pretreatment pulmonary interstitial change (PIC) has been indicated as a risk factor of severe radiation pneumonitis (RP) following stereotactic body radiation therapy (SBRT) for early-stage lung cancer, but details of its true effect remain unclear. This study aims to evaluate treatment outcomes of SBRT for stage I non-small cell lung cancer in patients with PIC. A total of 242 patients are included in this study (88% male). The median age is 77 years (range, 55–92 years). A total dose of 40–70 Gy is administered in 4 to 10 fractions during a 4-to-25 day period. One, two, and three-year overall survival (OS) rates are 82.1%, 57.1%, and 42.6%, respectively. Fatal RP is identified in 6.9% of all patients. The percent vital capacity <70%, mean percentage normal lung volume receiving more than 20 Gy (>10%), performance status of 2–4, presence of squamous cell carcinoma, clinical T2 stage, regular use of steroid before SBRT, and percentage predicting forced expiratory volume in one second (<70%) are associated with worse prognoses for OS. Our results indicate that fatal RP frequently occurs after SBRT for stage I lung cancer in patients with PIC.

【 授权许可】

Unknown