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Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer
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  • Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer
  • Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer
저자명
Kim. Myung-Soo,Lee. Ji-Hae,Ha. Bo-Ram,Lee. Re-Na,Lee. Kyung-Ja,Suh. Hyun-Suk
간행물명
Radiation oncology journal : ROJ
권/호정보
2011년|29권 3호|pp.181-190 (10 pages)
발행정보
대한방사선종양학회
파일정보
정기간행물|ENG|
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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기타언어초록

Purpose: Thoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy. This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after definitive radiotherapy in stage III non-small cell cancer patients. Materials and Methods: The medical records were reviewed for 49 patients who completed definitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently. Results: Twenty-five cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location, total radiation dose and chemotherapy were associated with grade ${geq}2$ radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was significantly related to grade ${geq}2$ radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), $V_{20}$, $V_{30}$, $V_{40}$, MLDipsi, $V_{20}$ipsi, $V_{30}$ipsi, and $V_{40}$ipsi were associated with grade ${geq}2$ radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ${geq}2$ radiation pneumonitis. Conclusion: Concurrent chemotherapy, MLD and $V_{30}$ were statistically significant predictors of grade ${geq}2$ radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing definitive radiotherapy. The cutoff values for MLD and $V_{30}$ were 16 Gy and 18%, respectively.