124P - Acute severe radiation pneumonitis in post-operation radiation therapy among patients with lung cancer: An analysis of dose-volume parameters

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Complications of Treatment
Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter Youling Gong
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors Y. Gong1, S. Wang2, Y. Xu1, J. Wang1, C. Sun3, S. Bai2, Y. Lu1, M. Huang1, Y. Wang1, L. Ren1
  • 1Department Of Thoracic Oncology, West China Hospital, Huaxi, Sichuan University, 610041 - Chengdu/CN
  • 2Radiation Physics Center, West China Hospital, Huaxi, Sichuan University, 610041 - Chengdu/CN
  • 3Department Of Radiation Oncology, Sichuan Cancer Hospital, 610045 - Chengdu/CN

Abstract

Background

Specific dose-volume histogram (DVH) parameters were previously reported to be the risk factors for radiation pneumonitis (RP) among patients with lung cancer. However, such relationships between the dosimetric factors and RP incidences were mostly discussed in a definitive treatment setting. Here, we retrospectively evaluated the possible predictive DVH parameters for acute severe RP in lung cancer patients treated with post-operation radiation therapy (PORT).

Methods

Eighty-five lung cancer patients treated with PORT was evaluated. Radiotherapy was delivered at 2 Gy per fraction to a total of 50–66 Gy. Acute RP was graded according to Common Terminology Criteria for Adverse Events, version 3.0. The percent lung volume receiving more than a threshold radiation dose (Vdose), and the mean lung dose (MLD) were analyzed for their association with risk of RP. This retrospective study was carried out with the approval of the Ethics Committee of West China Hospital, Sichuan University.

Results

Twenty-eight patients (32.9%) developed acute grade 2 RP, twenty-two patients (25.9%) developed acute grade 3 or worse RP, and one patient died of grade 5 RP. By multivariate analysis, the V5 of the ipsilateral lung (V5-Ip) and the V20 of the total lung (V20-Total) were significantly associated with G3 or higher acute RP (p = 0.023 and p = 0.029, respectively). By receiver operating characteristics curve analysis (ROC), the areas under curve were 0.659 (p = 0.027) and 0.666 (p = 0.021) for V5-Ip and V20-Total, respectively. The optimal V5-Ip threshold to predict acute severe RP was 71.2%, with sensitivity/specificity of 68.2%/61.9%. The optimal V20-Total threshold was 21.4%, and its sensitivity and specificity were 63.6% and 71.4% respectively.

Conclusions

V5-Ip and V20-Total were the predictive factors of acute severe RP among lung cancer patients treated with PORT. And it should be considered in the evaluation of treatment planning and require further investigation.

Clinical trial identification

Legal entity responsible for the study

West China Hospital

Funding

West China Hospital

Disclosure

All authors have declared no conflicts of interest.