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Simple Factors Associated With Radiation-Induced Lung Toxicity After Stereotactic Body Radiation Therapy of the Thorax: A Pooled Analysis of 88 Studies
- Publication Year :
- 2016
- Publisher :
- The University of North Carolina at Chapel Hill University Libraries, 2016.
-
Abstract
- To study the risk factors for radiation-induced lung toxicity (RILT) after stereotactic body radiation therapy (SBRT) of the thorax.Published studies on lung toxicity in patients with early-stage non-small cell lung cancer (NSCLC) or metastatic lung tumors treated with SBRT were pooled and analyzed. The primary endpoint was RILT, including pneumonitis and fibrosis. Data of RILT and risk factors were extracted from each study, and rates of grade 2 to 5 (G2+) and grade 3 to 5 (G3+) RILT were computed. Patient, tumor, and dosimetric factors were analyzed for their correlation with RILT.Eighty-eight studies (7752 patients) that reported RILT incidence were eligible. The pooled rates of G2+ and G3+ RILT from all 88 studies were 9.1% (95% confidence interval [CI]: 7.15-11.4) and 1.8% (95% CI: 1.3-2.5), respectively. The median of median tumor sizes was 2.3 (range, 1.4-4.1) cm. Among the factors analyzed, older patient age (P=.044) and larger tumor size (the greatest diameter) were significantly correlated with higher rates of G2+ (P=.049) and G3+ RILT (P=.001). Patients with stage IA versus stage IB NSCLC had significantly lower risks of G2+ RILT (8.3% vs 17.1%, odds ratio = 0.43, 95% CI: 0.29-0.64, P.0001). Among studies that provided detailed dosimetric data, the pooled analysis demonstrated a significantly higher mean lung dose (MLD) (P=.027) and V20 (P=.019) in patients with G2+ RILT than in those with grade 0 to 1 RILT.The overall rate of RILT is relatively low after thoracic SBRT. Older age and larger tumor size are significant adverse risk factors for RILT. Lung dosimetry, specifically lung V20 and MLD, also significantly affect RILT risk.
- Subjects :
- Male
Oncology
Thorax
Cancer Research
Lung Neoplasms
medicine.medical_treatment
Comorbidity
030218 nuclear medicine & medical imaging
0302 clinical medicine
Risk Factors
Carcinoma, Non-Small-Cell Lung
Stage (cooking)
Aged, 80 and over
Radiation
Incidence
Radiotherapy Dosage
Middle Aged
respiratory system
Causality
Treatment Outcome
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
medicine.medical_specialty
animal structures
Radiosurgery
Sensitivity and Specificity
Article
03 medical and health sciences
Age Distribution
Internal medicine
medicine
Carcinoma
Humans
Radiology, Nuclear Medicine and imaging
Aged
Pneumonitis
Lung
business.industry
Reproducibility of Results
Dose-Response Relationship, Radiation
medicine.disease
Confidence interval
respiratory tract diseases
Radiation Pneumonitis
Radiation therapy
body regions
business
Nuclear medicine
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....ae7ed2bbc376831c33174021a11cac40
- Full Text :
- https://doi.org/10.17615/rbq6-pq73