論文

国際誌
2020年7月

Radiation pneumonitis after definitive concurrent chemoradiotherapy with cisplatin/docetaxel for non-small cell lung cancer: Analysis of dose-volume parameters.

Cancer medicine
  • Kuniaki Katsui
  • ,
  • Takeshi Ogata
  • ,
  • Kenta Watanabe
  • ,
  • Norihisa Katayama
  • ,
  • Masahiro Kuroda
  • ,
  • Katsuyuki Kiura
  • ,
  • Takao Hiraki
  • ,
  • Yoshinobu Maeda
  • ,
  • Shinichi Toyooka
  • ,
  • Susumu Kanazawa

9
13
開始ページ
4540
終了ページ
4549
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/cam4.3093

BACKGROUND: Radiation pneumonitis (RP) is a major pulmonary adverse event of chest radiotherapy. The PACIFIC trial that identified durvalumab as an effective subsequent-line therapy after concurrent chemoradiotherapy (CCRT) found that patients with grade 2 or higher RP may have to be excluded from treatment under certain criteria. The purpose of this study was to investigate the relationship between grade ≥2 RP and the parameters of dose-volume histograms after CCRT with cisplatin/docetaxel for stage III non-small cell lung cancer and conduct a subset analysis of severe RP that can lead to the permanent discontinuation of treatment per the PACIFIC trial criteria to help determine treatment strategy. METHODS: We calculated the percentage of the lung volume received at least 5 Gy (V5) and 20 Gy (V20), the mean lung dose (MLD), and the lung volume spared from a 5 Gy dose (VS5) to the total lung volume. Factors affecting the incidence of grade ≥2 RP were identified; severe RP was defined as grade ≥3 as well as grade 2 RP that required ≥10 mg prednisolone for at least 12 weeks. RESULTS: This study included 45 patients. On univariate analysis, all parameters and total lung volume were found to be significant predictors of grade ≥2 RP (P = .001, .003, .03, .004, and .02, respectively). On multivariate analysis, V20 was a significant predictive factor of grade ≥2 RP (P = .007). Severe RP developed in 6 of 37 patients (16.2%) whose V20 values were 35% or lower. On univariate analysis, only V20 was a significant predictor of severe RP in these patients (P = .01). CONCLUSIONS: The best approach to reduce the rate of grade ≥2 RP is to maintain the V5, V20, MLD, and VS5 as low as possible during radiotherapy planning in patients receiving definitive CCRT with cisplatin/docetaxel.

リンク情報
DOI
https://doi.org/10.1002/cam4.3093
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32364685
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333825
ID情報
  • DOI : 10.1002/cam4.3093
  • PubMed ID : 32364685
  • PubMed Central 記事ID : PMC7333825

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