Stereotactic Body Radiation Therapy for Patients with Pulmonary Interstitial Change: High Incidence of Fatal Radiation Pneumonitis in a Retrospective Multi-Institutional Study

被引：29

作者：

Onishi, Hiroshi ^{[1
]}

Yamashita, Hideomi ^{[2
]}

Shioyama, Yoshiyuki ^{[3
]}

Matsumoto, Yasuo ^{[4
]}

Takayama, Kenji ^{[5
]}

Matsuo, Yukinori ^{[5
]}

Miyakawa, Akifumi ^{[6
]}

Matsushita, Haruo ^{[7
]}

Aoki, Masahiko ^{[8
]}

Nihei, Keiji ^{[9
]}

Kimura, Tomoki ^{[10
]}

Ishiyama, Hiromichi ^{[11
]}

Murakami, Naoya ^{[12
]}

Nakata, Kensei ^{[13
]}

Takeda, Atsuya ^{[14
]}

Uno, Takashi ^{[15
]}

Nomiya, Takuma ^{[16
]}

Takanaka, Tuyoshi ^{[17
]}

Seo, Yuji ^{[18
]}

Komiyama, Takafumi ^{[1
]}

Marino, Kan ^{[1
]}

Aoki, Shinichi ^{[1
]}

Saito, Ryo ^{[1
]}

Araya, Masayuki ^{[1
]}

Maehata, Yoshiyasu ^{[1
]}

Tominaga, Licht ^{[1
]}

Kuriyama, Kengo ^{[1
]}

机构：

[1] Univ Yamanashi, Sch Med, Dept Radiol, 1110 Shimokato, Chuo, Yamanashi 4093898, Japan

[2] Univ Tokyo Hosp, Dept Radiol, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1138655, Japan

[3] SAGA HIMAT Fdn, Ion Beam Therapy Ctr, 3049 Harukoga Machi, Tosu, Saga 8410071, Japan

[4] Niigata Canc Ctr Hosp, Dept Radiat Oncol, Chuo Ku, 2-15-3 Kawagishi, Niigata 9518566, Japan

[5] Kyoto Univ, Grad Sch Med, Dept Radiat Oncol & Image Appl Therapy, Sakyo Ku, 54 Kawaharacho, Kyoto 6068507, Japan

[6] Nagoya City Univ, Sch Med, Dept Radiol, Mizuho Ku, 1 Kawasumi,Mizuho Cho, Nagoya, Aichi 4678601, Japan

[7] Tohoku Univ, Sch Med, Dept Radiat Oncol, Aoba Ku, 2-1 Seiryo Machi, Sendai, Miyagi 9808574, Japan

[8] Hirosaki Univ, Sch Med, Dept Radiol & Radiat, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan

[9] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Radiat Oncol, Bunkyo Ku, 3-18-22 Honkomagome, Tokyo 1138677, Japan

[10] Hiroshima Univ Hosp, Dept Radiat Oncol, Minami Ku, 1-2-3 Kasumi, Hiroshima 7348551, Japan

[11] Kitasato Univ, Dept Radiat Oncol, Sch Med, Minami Ku, 1-15-1 Kitasato, Sagamihara, Kanagawa 2520375, Japan

[12] Natl Canc Ctr, Dept Radiat Oncol, Chuo Ku, 5-1-1 Tsukiji, Tokyo 1040045, Japan

[13] Sapporo Med Univ, Dept Radiat Oncol, Chuo Ku, 16-291 Minami 1jyo Nishi, Sapporo, Hokkaido 0608543, Japan

[14] Ofuna Chuo Hosp, Radiat Oncol Ctr, 6-2-24 Ofuna, Kamakura, Kanagawa 2470056, Japan

[15] Chiba Univ, Grad Sch Med, Diagnost Radiol & Radiat Oncol, Chuo Ku, 1-8-1 Inohana, Chiba, Chiba 2608670, Japan

[16] Yamagata Univ, Fac Med, Dept Radiat Oncol, 2-2-2 Iida Nishi, Yamagata, Yamagata 9909585, Japan

[17] Kanazawa Univ, Dept Radiat Oncol, 13-1 Takaramachi, Kanazawa, Ishikawa 9208641, Japan

[18] Osaka Univ, Dept Radiat Oncol, Grad Sch Med, 2-2 D10 Yamada Oka, Suita, Osaka 5650871, Japan

来源：

CANCERS | 2018年 / 10卷 / 08期

基金：

日本学术振兴会;

关键词：

stereotactic body radiation therapy; lung cancer; pulmonary interstitial change; radiation pneumonitis; CELL LUNG-CANCER; ACUTE EXACERBATION; RADIOTHERAPY; DISEASE; IMPACT; TUMORS; RISK; FIBROSIS;

D O I：

10.3390/cancers10080257

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Pretreatment pulmonary interstitial change (PIC) has been indicated as a risk factor of severe radiation pneumonitis (RP) following stereotactic body radiation therapy (SBRT) for early-stage lung cancer, but details of its true effect remain unclear. This study aims to evaluate treatment outcomes of SBRT for stage I non-small cell lung cancer in patients with PIC. A total of 242 patients are included in this study (88% male). The median age is 77 years (range, 55-92 years). A total dose of 40-70 Gy is administered in 4 to 10 fractions during a 4-to-25 day period. One, two, and three-year overall survival (OS) rates are 82.1%, 57.1%, and 42.6%, respectively. Fatal RP is identified in 6.9% of all patients. The percent vital capacity <70%, mean percentage normal lung volume receiving more than 20 Gy (>10%), performance status of 2-4, presence of squamous cell carcinoma, clinical T2 stage, regular use of steroid before SBRT, and percentage predicting forced expiratory volume in one second (<70%) are associated with worse prognoses for OS. Our results indicate that fatal RP frequently occurs after SBRT for stage I lung cancer in patients with PIC.

引用

页数：11

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