Predictive factors for severe radiation-induced lung injury in patients with lung cancer and coexisting interstitial lung disease

被引：9

作者：

Park, Shin-Hyung ^{[1
,2
,7
]}

Lim, Jae-Kwang ^{[3
]}

Kang, Min Kyu ^{[1
]}

Park, Jongmoo ^{[1
]}

Hong, Chae Moon ^{[4
]}

Kim, Chang Ho ^{[5
]}

Cha, Seung Ick ^{[5
]}

Lee, Jaehee ^{[5
]}

Lee, Seoung-Jun ^{[6
]}

Kim, Jae-Chul ^{[1
]}

机构：

[1] Kyungpook Natl Univ, Sch Med, Dept Radiat Oncol, Daegu, South Korea

[2] Kyungpook Natl Univ, Cardiovasc Res Inst, Sch Med, Daegu, South Korea

[3] Kyungpook Natl Univ, Sch Med, Dept Radiol, Daegu, South Korea

[4] Kyungpook Natl Univ, Sch Med, Dept Nucl Med, Daegu, South Korea

[5] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea

[6] Kyungpook Natl Univ Hosp, Dept Radiat Oncol, Daegu, South Korea

[7] Kyungpook Natl Univ, Sch Med, Dept Radiat Oncol, 130 Dongduk Ro, Daegu 41944, South Korea

来源：

RADIOTHERAPY AND ONCOLOGY | 2024年 / 192卷

基金：

新加坡国家研究基金会;

关键词：

Lung neoplasms; Lung disease; interstitial; Radiation pneumonitis; Radiotherapy; Biomarkers; Neutrophils; Lymphocytes; IDIOPATHIC PULMONARY-FIBROSIS; ORGANIZING PNEUMONIA SYNDROME; BREAST-CONSERVING THERAPY; ACUTE EXACERBATION;

D O I：

10.1016/j.radonc.2023.110053

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background and purpose: This study aimed to investigate the predictive factors of severe radiation-induced lung injury (RILI) in patients with lung cancer and coexisting interstitial lung disease (ILD) undergoing conventionally fractionated thoracic radiotherapy. Materials and methods: The study includes consecutive patients treated with thoracic radiotherapy for lung cancer at two tertiary centers between 2010 and 2021. RILI severity was graded using the National Cancer Institute Common Terminology Criteria version 5.0, with severe RILI defined as toxicity grade >= 4, and symptomatic RILI as grade >= 2. The absolute neutrophil count (ANC), absolute lymphocyte count (ALC), and C-reactive protein were collected within 4 weeks before starting radiotherapy. Neutrophil-lymphocyte ratios (NLR) were calculated as ANC/ALC. The median follow-up was 9 (range, 6-114) months. Results: Among 54 patients, 22 (40.7 %) had severe RILI. On multivariate logistic regression analysis, high pretreatment ANC (p = 0.030, OR = 4.313), pretreatment NLR (p = 0.007, OR = 5.784), and ILD severity (p = 0.027, OR = 2.416) were significant predictors of severe RILI. Dosimetric factors were not associated with severe RP. Overall survival was significantly worse for patients with severe RILI than those without, with 1-year cumulative overall survival rates of 7.4 % and 62.8 %, respectively. Conclusion: Pretreatment blood NLR, ANC, and ILD severity were associated with severe RILI. Overall survival was dismal for patients with severe RILI.

引用

页数：8

共 33 条

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