Influencing Factors for Acute Radiation Pneumonitis in Non-operative Esophageal Cancer after Radiotherapy_West China Medical Journal

Authors：

 ZHAOYa-qin ¹ , RONGLi-wen ¹ , FENGXu-qin ¹ , ZHUHong ¹ , ZHANGYing-jie ² ,  LIZhi-ping ¹

1. Department of Abdominal Oncology, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Radiological Physics Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIZhi-ping, Email: lizhiping620312@163.com

Keywords：

Acute radiation pneumonitis; Radiotherapy for esophageal cancer; Influencing factors

DOI：

10.7507/1002-0179.20140616

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the clinical and dosimetric impacts on radiation pneumonitis (RP), and provides data for radiotherapy planning. Methods We reviewed 59 non-operative esophageal cancer patients who underwent radiotherapy from October 2010 to November 2012 to identify the correlation between the clinical and dosimetric parameters with acute radiation pneumonitis (ARP) and severe acute radiation pneumonitis (SARP) by t-Test, Chi-Square Test and logistic regression analysis. Results Among the 59 patients, 33 (55.9%) developed ARP, in whom 9 (15.3%) developed SARP. Univariate analysis showed that lung infection during radiotherapy, mean lung dose (MLD), and dosimetric parameters are significantly correlated with RP. Multivariate analysis revealed lung infection during radiotherapy, MLD≥13 Gy, and V₃₀≥13% were significantly correlated with the increasing risk RP. Conclusion Lung infection during radiotherapy, MLD, and V₃₀ are the influencing factors of RP, which should be seriously considered when formulating radiotherapy plan to avoid RP.

Citation： ZHAOYa-qin, RONGLi-wen, FENGXu-qin, ZHUHong, ZHANGYing-jie, LIZhi-ping. Influencing Factors for Acute Radiation Pneumonitis in Non-operative Esophageal Cancer after Radiotherapy. West China Medical Journal, 2014, 29(11): 2036-2041. doi: 10.7507/1002-0179.20140616 Copy

1.	Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013[J]. CA Cancer J Clin, 2013, 63(1):11-30.
2.	Lin Y, Totsuka Y, He Y, et al. Epidemiology of esophageal cancer in Japan and China[J]. J Epidemiol, 2013, 23(4):233-242.
3.	Cox JD, Stetz J, Pajak TF. Toxicit y criteria of the radiation therapy oncology group (RTOG) and the European orqanization for research and treatment of cancer (EORTC)[J]. Int J Radiat Oncol Biol Phys, 1995, 31(5):1341-1346.
4.	祝淑钗, 沈文斌, 李任, 等. 三维适形放疗食管癌所致放射性肺炎相关因素分析[J]. 中华放射医学与防护杂志, 2007, 27(2):161-164.
5.	Trott KR, Herrmann T, Kasper M. Target cells in radiation pneumopathy[J]. Int J Radiat Oncol Biol Phys, 2004, 58(2):463-469.
6.	Molteni A, Wolfe LF, Ward WF, et al. Effect of an angiotensin Ⅱ receptor blocker and two angiotensin converting enzyme inhibitors on transforming growth factor-beta (TGF-beta) and alpha-actomyosin (alpha SMA), important mediators of radiation-induced pneumopathy and lung fibrosis[J]. Curr Pharm Des, 2007, 13(13):1307-1316.
7.	Murray LA, Chen Q, Kramer MS, et al. TGF-beta driven lung fibrosis is macrophage dependent and blocked by Serum amyloid P[J]. Int J Biochem Cell Biol, 2011, 43(1):154-162.
8.	Hill RP, Zaidi A, Mahmood J, et al. Investigations into the role of inflammation in normal tissue response to irradiation[J]. Radiother Oncol, 2011, 101(1):73-79.
9.	许泽苹, 林连兴, 许少生, 等. 食管癌三维适形放疗中肺损伤的相关因素分析[J]. 当代医学, 2011, 17(26):109-110.
10.	Dang J, Li G, Lu X, et al. Analysis of related factors associated with radiation pneumonitis in patients with locally advanced non-small-cell lung cancer treated with three-dimensional conformal radiotherapy[J]. J Cancer Res Clin Oncol, 2010, 136(8):1169-1178.
11.	Graham MV, Purdy JA, Emami B, et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC)[J]. Int J Radiat Oncol Biol Phys, 1999, 45(2):323-329.
12.	Tsujino K, Hirota S, Endo M, et al. Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer[J]. Int J Radiat Oncol Biol Phys, 2003, 55(1):110-115.
13.	Rodrigues G, Lock M, D'souza D, et al. Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer:a systematic review[J]. Radiother Oncol, 2004, 71(2):127-138.
14.	赵快乐, 施学辉, 蒋国梁. 用剂量体积直方图评估放射性肺损伤[J]. 中华放射肿瘤学杂志, 2002, 11(1):69-70.
15.	Mccurdy M, Mcaleer MF, Wei W, et al. Induction and concurrent taxanes enhance both the pulmonary metabolic radiation response and the radiation pneumonitis response in patients with esophagus cancer[J]. Int J Radiat Oncol Biol Phys, 2010, 76(3):816-823.
16.	Kong FM, Hayman JA, Griffith KA, et al. Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (NSCLC):predictors for radiation pneumonitis and fibrosis[J]. Int J Radiat Oncol Biol Phys, 2006, 65(4):1075-1086.
17.	Asakura H, Hashimoto T, Zenda S, et al. Analysis of dose-volume histogram parameters for radiation pneumonitis after definitive concurrent chemoradiotherapy for esophageal cancer[J]. Radiother Oncol, 2010, 95(2):240-244.
18.	Marks LB, Spencer DP, Sherouse GW, et al. The role of three dimensional functional lung imaging in radiation treatment planning:the functional dose-volume histogram[J]. Int J Radiat Oncol Biol Phys, 1995, 33(1):65-75.

1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013[J]. CA Cancer J Clin, 2013, 63(1):11-30.
2. Lin Y, Totsuka Y, He Y, et al. Epidemiology of esophageal cancer in Japan and China[J]. J Epidemiol, 2013, 23(4):233-242.
3. Cox JD, Stetz J, Pajak TF. Toxicit y criteria of the radiation therapy oncology group (RTOG) and the European orqanization for research and treatment of cancer (EORTC)[J]. Int J Radiat Oncol Biol Phys, 1995, 31(5):1341-1346.
4. 祝淑钗, 沈文斌, 李任, 等. 三维适形放疗食管癌所致放射性肺炎相关因素分析[J]. 中华放射医学与防护杂志, 2007, 27(2):161-164.
5. Trott KR, Herrmann T, Kasper M. Target cells in radiation pneumopathy[J]. Int J Radiat Oncol Biol Phys, 2004, 58(2):463-469.
6. Molteni A, Wolfe LF, Ward WF, et al. Effect of an angiotensin Ⅱ receptor blocker and two angiotensin converting enzyme inhibitors on transforming growth factor-beta (TGF-beta) and alpha-actomyosin (alpha SMA), important mediators of radiation-induced pneumopathy and lung fibrosis[J]. Curr Pharm Des, 2007, 13(13):1307-1316.
7. Murray LA, Chen Q, Kramer MS, et al. TGF-beta driven lung fibrosis is macrophage dependent and blocked by Serum amyloid P[J]. Int J Biochem Cell Biol, 2011, 43(1):154-162.
8. Hill RP, Zaidi A, Mahmood J, et al. Investigations into the role of inflammation in normal tissue response to irradiation[J]. Radiother Oncol, 2011, 101(1):73-79.
9. 许泽苹, 林连兴, 许少生, 等. 食管癌三维适形放疗中肺损伤的相关因素分析[J]. 当代医学, 2011, 17(26):109-110.
10. Dang J, Li G, Lu X, et al. Analysis of related factors associated with radiation pneumonitis in patients with locally advanced non-small-cell lung cancer treated with three-dimensional conformal radiotherapy[J]. J Cancer Res Clin Oncol, 2010, 136(8):1169-1178.
11. Graham MV, Purdy JA, Emami B, et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC)[J]. Int J Radiat Oncol Biol Phys, 1999, 45(2):323-329.
12. Tsujino K, Hirota S, Endo M, et al. Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer[J]. Int J Radiat Oncol Biol Phys, 2003, 55(1):110-115.
13. Rodrigues G, Lock M, D'souza D, et al. Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer:a systematic review[J]. Radiother Oncol, 2004, 71(2):127-138.
14. 赵快乐, 施学辉, 蒋国梁. 用剂量体积直方图评估放射性肺损伤[J]. 中华放射肿瘤学杂志, 2002, 11(1):69-70.
15. Mccurdy M, Mcaleer MF, Wei W, et al. Induction and concurrent taxanes enhance both the pulmonary metabolic radiation response and the radiation pneumonitis response in patients with esophagus cancer[J]. Int J Radiat Oncol Biol Phys, 2010, 76(3):816-823.
16. Kong FM, Hayman JA, Griffith KA, et al. Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (NSCLC):predictors for radiation pneumonitis and fibrosis[J]. Int J Radiat Oncol Biol Phys, 2006, 65(4):1075-1086.
17. Asakura H, Hashimoto T, Zenda S, et al. Analysis of dose-volume histogram parameters for radiation pneumonitis after definitive concurrent chemoradiotherapy for esophageal cancer[J]. Radiother Oncol, 2010, 95(2):240-244.
18. Marks LB, Spencer DP, Sherouse GW, et al. The role of three dimensional functional lung imaging in radiation treatment planning:the functional dose-volume histogram[J]. Int J Radiat Oncol Biol Phys, 1995, 33(1):65-75.

West China Medical Journal

Influencing Factors for Acute Radiation Pneumonitis in Non-operative Esophageal Cancer after Radiotherapy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content