Heart irradiation as a risk factor for radiation pneumonitis.
Acta Oncol
; 50(1): 51-60, 2011 Jan.
Article
de En
| MEDLINE
| ID: mdl-20874426
ABSTRACT
PURPOSE:
to investigate the potential role of incidental heart irradiation on the risk of radiation pneumonitis (RP) for patients receiving definitive radiation therapy for non-small-cell lung cancer (NSCLC). MATERIAL ANDMETHODS:
two hundred and nine patient datasets were available for this study. Heart and lung dose-volume parameters were extracted for modeling, based on Monte Carlo-based heterogeneity corrected dose distributions. Clinical variables tested included age, gender, chemotherapy, pre-treatment weight-loss, performance status, and smoking history. The risk of RP was modeled using logistic regression.RESULTS:
the most significant univariate variables were heart related, such as heart heart V65 (percent volume receiving at least 65 Gy) (Spearman Rs = 0.245, p < 0.001). The best-performing logistic regression model included heart D10 (minimum dose to the hottest 10% of the heart), lung D35, and maximum lung dose (Spearman Rs = 0.268, p < 0.0001). When classified by predicted risk, the RP incidence ratio between the most and least risky 1/3 of treatments was 4.8. The improvement in risk modeling using lung and heart variables was better than using lung variables alone.CONCLUSIONS:
these results suggest a previously unsuspected role of heart irradiation in many cases of RP.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Pneumopathie infectieuse
/
Lésions radiques
/
Carcinome pulmonaire non à petites cellules
/
Coeur
/
Tumeurs du poumon
Type d'étude:
Etiology_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Acta Oncol
Sujet du journal:
NEOPLASIAS
Année:
2011
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique