Study on prediction models for severe acute radiation pneumonitis in patients with non-small cell lung cancer after concurrent chemoradiotherapy
WANG Jin*,BAO Yon, ZHUANG Ting-ting, ZHANG Li, HE Zhi-chun, TAI An, MA Hong-Lian, HU Xiao, ZHOU Qi-chao, PENG Fang, XU Yu-jin, DENG Xiao-wu, CHEN Ming.*
Department of Radiation Oncology, Zhejiang Cancer Hospital, Key Laboratory of Radiation Oncology in Zhejiang Provnce, Hangzhou 310022, China
Abstract：Objective To establish the Logistic dose response model and Lyman-Kutcher-Burman (LKB)-normal tissue complication probability (NTCP) model using dose-volume histogram (DVH) parameters and to evaluate their predictive values for severe acute radiation pneumonitis (SARP) in patients with non-small cell lung cancer (NSCLC) after concurrent chemotherapy and three-dimensional conformal radiotherapy (3DCRT). Methods The clinical data of 147 NSCLC patients who were treated with concurrent chemotherapy and 3DCRT from 2006 to 2010 were collected. According to RTOG criteria, grade 3 or even severer acute radiation pneumonitis was defined as SARP. The Logistic dose response model and LKB-NTCP model were established according to DVH dosimetric information. Results The incidence of SARP was 9.5%(14/147). The best-fit parameter values for Logistic dose response model were shown as follows:constant b0=－6.66;constant b1=0.252;TD50=26.43 Gy;γ50=1.67. The fit curve was relatively flat when the maximum limit dose (MLD) was<17 Gy, and it became sharper when the MLD was 17－18 Gy, which implied that the risk of SARP increased. The best-fit parameter values for LKB-NTCP model were shown as follows:volume factor n= 0.87±0.40;slope factor m= 0.27±0.10;TD50(1)=(29.5±8.0) Gy. The Logistic regression analysis and receiver operating characteristic (ROC) analysis showed that the NTCP value calculated using the parameter values had a good predictive value for SARP (Logistic regression:P=0.013;area under the ROC curve:0.707,P=0.019). Conclusions The predictive value of NTCP for SARP is better than simple dose parameters. The two model curves suggest that MLD is above 17 Gy.
. Study on prediction models for severe acute radiation pneumonitis in patients with non-small cell lung cancer after concurrent chemoradiotherapy[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 455-458.
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2013, Vol. 22 
