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Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 25-29

Radiation pneumonitis in non-small-cell lung cancer patients treated with helical tomotherapy

Department of Radiation Oncology, Military General Hospital of Beijing PLA, Beijing, China

Correspondence Address:
B Yao
No. 5 Nanmencang, Dongsishitiao Street, Dongcheng, Beijing 100700
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1119-3077.173709

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Objective: In this study, we investigated the incidence of radiation pneumonitis (RP) in non-small-cell lung cancer (NSCLC) patients undergoing helical tomotherapy (HT) and the clinical and dosimetric factors associated with it. Materials and Methods: We analyzed data from the treatment protocols of 62 NSCLC patients. The median total radiation dose was 64 Gy (range 57.6–66 Gy) at 1.8–2.2 Gy/fraction. Thirty-four of these patients underwent HT alone and 28 underwent HT in combination with chemotherapy. Treatment-related pneumonitis was graded according to the Common Terminology Criteria for Adverse Events, version 3.0. Results: We found that RP grades 1, 2, 3 and 5 occurred in 29 (46.8%), 23 (37.1%), 8 (12.9%), and 2 (3.2%) patients, respectively. Using univariate analyses, we found that a grade ≥3 RP was associated with poor performance status (PS), age, planning target volume, mean lung dose, and relative V5through V25, in increments of 5 Gy (P < 0.005). We determined that PS and V5V15were the most significant factors associated with grade ≥3 RP using multivariate analysis. Conclusions: We found that poor PS and V5–V15 were the risk factors associated with grade ≥3 RP in NSCLC patients treated with HT. Thus, for NSCLC patients treated with HT, the volume of total lung with low-dose region (V5–V15) should be carefully regulated and the use of HT should be restricted in patients with Eastern Cooperative Oncology Group ≥2.

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