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Neoplasma Vol.52, p.56-62, 2005 |
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Title: Prediction of radiation pneumonitis: dose-volume histogram analysis in 62 patients with non-small cell lung cancer after three-dimensional conformal radiotherapy | ||
Author: T., PIOTROWSKI ; M., MATECKA-NOWAK ; P., MILECKI ; | ||
Abstract: The purpose of the study was to determine the relation between the
incidence of radiation pneumonitis (RP) and available parameters
from a dose-volume histogram (DVH) in patients with non-small cell
lung cancer (NSCLC) who underwent three-dimensional conformal
radiotherapy treatment.
Between January 1999 and August 2003 in the Greatpoland Cancer
Center, 62 patients with NSCLC were treated using three-
dimensional conformal radiotherapy (3D CRT). All patients were
treated 5 days per week with daily fractionation of 2 Gy to total
dose of 60 Gy. All patients were available for analysis for
symptomatic RP. Radiation pneumonitis was graded according to the
RTOG/EORTC morbidity scoring classification. Logistic regression
analysis was performed to test the association between RP and the
following DVH parameters: mean lung dose (MLD), volume of lung
receiving ż20 Gy (V20 ) and ż30 Gy (V30) and normal tissue
complication probability (NTCP). Additionally, correlation of the
following clinical factors such as: age, sex, tumor site,
performance status (KPS), and additional therapy (chemotherapy)
with incidence of the RP were performed. Moreover, correlation
between DVH parameters were tested using Spearman method.
Thirty out of 62 patients (48%) developed RP grade 0 or 1 (0
grade -- 12%, 1 grade -- 36%) and 32 (52%) grade 2 or 3 (2 grade --
47%, 3 grade -- 5%). In the logistic regression analysis, all DVH
parameters were associated with RP (p in range from 0.004 to
0.007). The strongest association was observed for NTCP and V30
(p=0.004). On the other hand, a weak association was found for V20
(p=0.007). The correlations between all DVH parameters for lung
were sufficient (r Spearman in range from 0.87 to 0.93). The best
correlation among DVH parameters were observed between V20 and
NTCP (r=0.93, p<0.001). On the other hand, the least but
sufficient association was found for V30 and V20 (r=0.87,
p<0.001). There was no association between clinical factors and RP.
NTCP and V30 parameters were the best predictors of symptomatic
radiation pneumonitis for patients after three-dimensional
conformal radiotherapy of non-small cell lung cancer.
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Keywords: NSCLC, radiotherapy, radiation pneumonitis, dose volume histogram | ||
Year: 2005, Volume: 52, Issue: | Page From: 56, Page To: 62 | |
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