DOSE-VOLUME ANALYSIS OF RADIATION PNEUMONITIS IN NON-SMALL-CELL LUNG CANCER PATIENTS TREATED WITH CONCURRENT CISPLATINUM AND ETOPOSIDE WITH OR WITHOUT CONSOLIDATION DOCETAXEL

Purpose To examine the rates and risk factors for radiation pneumonitis (RP) in non small-cell lung cancer (NSCLC) patients treated with chemoradiotherapy Methods and Materials We reviewed dosimetry records from Stage HI NSCLC patients treated on a prospective randomized trial Patients received concurrent cisplatinum/etoposide with radiation therapy to 59 4Gy A total of 243 patients were enrolled, 167 did not experience progression and were randomized to observation (OB) or con solidation docetaxel (CD) Toxicity was coded based on the presence of Grade 0 to 1 vs Grade 2 to 5 RP using the Common Toxicity Criteria and Adverse Events (CTCAE) v3 0 Results Median age and follow up were 63 years and 16 months, respectively Overall, Grade 0 to 1 and Grade 2 to 5 RP were reported in 226 patients and 17 patients (7%) respectively Median mean lung dose (MLD), V5, V20, and V30 for evaluable patients were 18 Gy, 52%, 35%, and 29% MLD in Grade 0 to 1 and Grade 2 to 5 patients was 1,748 c Gy and 2,013 cGy in respectively (p = 0 12) Grade 2 to 5 RP developed in 2 2% and 19% of patients with MLD < 18 Gy and MLD > 18 Gy, respectively (p = 0 015) Mean V20 was 33 7% and 37 7% for Grade 0 to 1 and Grade 2 to 5 groups, respectively (p = 0 29) Grade 2 to 5 RP developed in 4 8% and 17% of patients with V20 < 35% and V20 > 35%, respectively The OB and CD groups had similar MLD and V20, and the RP rates were 3 6% and 14 6%, respectively (p = 0 015) Patients who developed Grade 0 to 1 and Grade 2 to 5 RP had similar mean V5, V10, V15, V20, V25, V30, age, smoking history, and tumor characteristics Conclusions The overall rate of Grade 2 to 5 RP was 7% in patients treated with chemoradiotherapy In this analysis, predictive factors for RP were MLD > 18 Gy and treatment with CD (C) 2010 Elsevier Inc