Radiation Oncology Journal

  • 제31권1호
  • /
  • Pages.34-40
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  • 2013
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
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Predictors of radiation pneumonitis and pulmonary function changes after concurrent chemoradiotherapy of non-small cell lung cancer

  • Park, Young Hee (Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Jae-Sung (Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • 투고 : 2012.10.28
  • 심사 : 2013.03.12
  • 발행 : 2013.03.31
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초록

Purpose: To evaluate the predictive factors of radiation pneumonitis (RP) and associated changes in pulmonary function after definitive concurrent chemoradiotherapy (CCRT) in patients with non-small cell lung cancer (NSCLC). Materials and Methods: Medical records of 60 patients with NSCLC who received definitive CCRT were retrospectively reviewed. Dose volumetric (DV) parameters, clinical factors, and pulmonary function test (PFT) data were analyzed. RP was graded according to the CTCAE ver. 4.0. Percentage of lung volume that received a dose of threshold (Vdose) and mean lung dose (MLD) were analyzed for potential DV predictors. PFT changes were calculated as the difference between pre-RT and post-RT values at 3, 6, and 12 months after RT. Results: Twenty-two patients (37%) developed grade ${\geq}2$ RP. Among clinical factors, tumor location in lower lobe was associated with RP. Among the DV parameters, only MLD >15 Gy was associated with grade ${\geq}2$ RP. There were statistically significant decreases in PFT at all points compared with pre-RT values in grade ${\geq}2$ RP group. MLD was associated with forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) changes at 6 and 12 months. V10 was associated with FVC changes at 12 months. V20 and V30 were associated with FEV1 changes at 6 months and FVC changes at 12 months. Conclusion: After definitive CCRT in patients with NSCLC, MLD >15 Gy and lower lobe tumor location were predictors of grade ${\geq}2$ RP. Pulmonary functions were decreased after CCRT and the magnitude of changes was associated with DV parameters.

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참고문헌

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  7. Impact of Low-Dose Irradiation of the Lung and Heart on Toxicity and Pulmonary Function Parameters after Thoracic Radiotherapy vol.13, pp.1, 2013, https://doi.org/10.3390/cancers13010022
  8. In Silico Ventilation Within the Dose-Volume is Predictive of Lung Function Post-radiation Therapy in Patients with Lung Cancer vol.49, pp.5, 2013, https://doi.org/10.1007/s10439-020-02697-5