[an error occurred while processing this directive] | [an error occurred while processing this directive]
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.
. 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.
[1] 王谨,庄婷婷,何智纯,等.非小细胞肺癌同期放化疗后重度急性放射性肺炎的预测因素. 中华放射肿瘤学杂志,2012,355:2542-2550. [2] Marks LB, Bentzen SM, Deasy JO, et al. Radiation dose-volume effects in the lung. Int J Radiat Oncol Biol Phys,2010,76(3 Suppl):S70-76. [3] Yorke ED, Jackson A, Rosenzweig KE, et al. Correlation of dosimetric factors and radiation pneumonitis for non-small-cell lung cancer patients in a recently completed dose escalation study. Int J Radiat Oncol Biol Phys,2005,63:672-682. [4] Seppenwoolde Y, Lebesque JV, de Jaeger K, et al. Comparing different NTCP models that predict the incidence of radiation pneumonitis. Normal tissue complication probability. Int J Radiat Oncol Biol Phys,2003,55:724-735. [5] Bentzen SM, Tucker SL. Quantifying the position and steepness of radiation dose-response curves. Int J Radiat Biol,1997,71:531-542. [6] Lyman JT. Complication probability as assessed from dose-volume histograms. Radiat Res Suppl,1985,8:13-19. [7] Tai A, Erickson B, Khater KA, et al. Estimate of radiobiologic parameters from clinical data for biologically based treatment planning for liver irradiation. Int J Radiat Oncol Biol Phys,2008,70:900-907. [8] 朱向炽,王绿化,王颖杰,等.三维适形放疗局部晚期非小细胞肺癌的放射性肺炎风险因素研究.中华放射肿瘤学杂志,2007,16:421-426. [9] 韩蕾,卢冰,付和谊,等.Ⅲ+Ⅳ期非小细胞肺癌三维适形或调强放疗中复合指标预测放射性肺炎前瞻性临床研究.中华放射肿瘤学杂志,2010,19:420-424. [10] 王静,王平,庞青松,等.非小细胞肺癌三维适形放疗放射性肺损伤临床及剂量学因素分析.中华放射肿瘤学杂志,2011,18:448-451. [11] Graham MV, Purdy JA, Emami B. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys,1999,45:323-329. [12] Kim TH, Cho KH, Pyo HR, et al. Dose-volumetric parameters for predicting severe radiation pneumonitis after three-dimensional conformal radiation therapy for lung cancer. Radiology,2005,235:208-215. [13] Wang S, Liao Z, Wei X, et al. Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT). Int J Radiat Oncol Biol Phys,2006,66:1399-1407. [14] Tucker SL, Jin H, Wei X, et al. Impact of toxicity grade and scoring system on the relationship between mean lung dose and risk of radiation pneumonitis in a large cohort of patients with non-small cell lung cancer. Int J Radiat Oncol Biol Phys,2010,77:691-698. [15] Fu XL, Huang H, Bentel G, et al. Predicting the risk of symptomatic radiation-induced lung injury using both the physical and biologic parameters V (30) and transforming growth factor beta. Int J Radiat Oncol Biol Phys,2001,50:899-908. [16] 姬巍,王绿化,赵路军,等.细胞因子联合DVH参数预测放射性肺炎的临床研究.中华放射肿瘤学杂志,2007,11:473-477.
2013, Vol. 22 
