1. Study of the predictors for radiation pneumonitis in patient with non-small cell lung cancer received radiotherapy after pneumonectomy
- Author
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X.-W. Cai, X.-L. Fu, C.-L. Wang, Changxing Lv, J. Liu, Q. Zhang, J.-H. Yu, J.-M. Wang, and Y. Liu
- Subjects
Male ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Sensitivity and Specificity ,03 medical and health sciences ,Pneumonectomy ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lung cancer ,Radiation Pneumonitis ,Retrospective Studies ,Postoperative Care ,Univariate analysis ,Receiver operating characteristic ,business.industry ,Incidence (epidemiology) ,Middle Aged ,Nomogram ,medicine.disease ,Tumor Burden ,Radiation therapy ,Nomograms ,ROC Curve ,Oncology ,030220 oncology & carcinogenesis ,Regression Analysis ,Female ,Radiology ,business - Abstract
To identify the valuable predictors of grade≥2 radiation pneumonitis (RP) in patient treated with radiotherapy after pneumonectomy for non-small cell lung cancer (NSCLC); and to construct a nomogram predicting the incidence of grade≥2 RP in such patients.We reviewed 82 patients with NSCLC received radiotherapy after pneumonectomy from 2008 to 2018. The endpoint was grade≥2 RP. Univariate and multivariate regression analysis were conducted to evaluate significant factors of grade≥2 RP. Receiver operating characteristic (ROC) curve was used to establish optimal cutoff values and the nomogram was built to make the predictive model visualized. Descriptive analysis was performed on 5 patients with grade 3 RP.A total of 22(26.8%) patients developed grade 2 RP and 5(6.1%) patients were grade 3 RP. V5, V10, V20, V30, MLD, PTV, and PTV/TLV were associated with the occurrence of grade≥2 RP in univariate analysis, while none of the clinical factors was significant; V5(OR,1.213;95%CI,1.099-1.339; P0.001) and V20(OR,1.435;95%CI,1.166-1.765; P=0.001) were the independent significant predictors by multivariate analysis and were included in the nomogram. The ROC analysis for the cutoff values for predicting grade≥2 RP were V523% (AUC=0.819, sensitivity:0.701, specificity:0.832) and V208% (AUC=0.812, sensitivity:0.683, specificity:0.811). Additionally, grade≥3 RP did not occur when V530%, V2013% and MLD751.2cGy, respectively.Our study showed that V5 and V20 were independent predictors for grade≥2 RP in NSCLC patients receiving radiotherapy after pneumonectomy. Grade 3 RP did not occur whenV530%, V2013% and MLD751.2cGy, respectively. In addition, patient underwent right pneumonectomy may have a lower tolerance to radiation compared to left pneumonectomy.
- Published
- 2021
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